So sánh đặc điểm toan chuyển hóa ở bệnh nhân ngộ độc cấp methanol và ethanol

Abstract

Objectives: To compare the characteristics of metabolic acidosis and some clinical features between acute methanol and ethanol poisoning. Subjects and Methods: An observational descriptive study was conducted in 41 patients with acute methanol intoxication and 33 patients with acute ethanol poisoning who presented with metabolic acidosis and were treated at the Poison Control Center of Bach Mai Hospital from 1/2015 to 08/2017. Results: The mean age of the methanol group was higher than that of the ethanol group (40.68 ± 14.3 vs. 32.79 ± 11.3). The percentage of alcoholism in the methanol group was significantly higher than in the ethanol group (70.7% vs. 9.09%, p<0.001). The pH, bicarbonate, base excess (BE) and anion gap (AG) were good values to differentiate methanol and ethanol poisoning (all AUCs were over 90%). Lactate and osmolar gap (OG) did not distinguish between the two types of alcohol poisoning with metabolic acidosis. The pH value <7.3, HCO3 <15 mmol/l, BE <-8 and AG >30 had the highest sensitivity and specificity. Other clinical symptoms which were significantly different between methanol and ethanol intoxication were late onset of symptoms, blurred vision, coma, hypotension, and respiratory failure. Conclusion: The study showed differences in the characteristics of metabolic acidosis and some accompanying symptoms that may help differentiate methanol from ethanol poisoning.