水杨酸水平预示结果
血清水杨酸水平在成人中>80 mg/dL或者在儿童或老年人中>70 mg/dL 提示重度中毒,并且提示有生命危险。[14]Dargan PI, Wallace CI, Jones AL. An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose. Emerg Med J. 2002;19:206-209.http://emj.bmj.com/content/19/3/206.fullhttp://www.ncbi.nlm.nih.gov/pubmed/11971828?tool=bestpractice.com 慢性水杨酸中毒且水杨酸水平达到 40 至 60 mg/dL 的患者病情严重,并且有死亡的风险。非致命性水杨酸中毒可以完全恢复。[14]Dargan PI, Wallace CI, Jones AL. An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose. Emerg Med J. 2002;19:206-209.http://emj.bmj.com/content/19/3/206.fullhttp://www.ncbi.nlm.nih.gov/pubmed/11971828?tool=bestpractice.com
需要注意的是在较低水平的水杨酸情况下,特别是在慢性摄入病例中,也可能出现大量临床体征和症状,特别是神经系统体征和非心源性肺水肿。所以单独水杨酸盐水平不能可靠地预测预后。
摄入至治疗时间
死亡和急性摄入的严重毒性风险随着摄入和治疗之间的时间延长而增加。一项研究表明如果大剂量水杨酸摄入和治疗之间间期超过 12 小时,则最终发病率和死亡率增加。[28]Done AK. Salicylate intoxication: significance of measurements of salicylate in blood in cases of acute ingestion. Pediatrics. 1960;26:800-807.http://www.ncbi.nlm.nih.gov/pubmed/13723722?tool=bestpractice.com 但是在文献中,报告的确切的中毒时间和预估的药物剂量差异很大。[1]Chyka PA, Erdman AR, Christianson G, et al. Salicylate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45:95-131.http://informahealthcare.com/doi/full/10.1080/15563650600907140http://www.ncbi.nlm.nih.gov/pubmed/17364628?tool=bestpractice.com