对乙酰氨基酚过量：病例报告与国家毒理学数据的系统综述（2018—2023年）。
完整摘要 · 中文译文
目的：对乙酰氨基酚作为解热镇痛药被广泛使用，但其易获得性也使其成为药物过量案例中的常见药物。故意对乙酰氨基酚中毒的发生率不断上升，尤其是在青少年中，引起了公共卫生方面的关注。本研究旨在探讨对乙酰氨基酚过量的近期模式，并识别故意自我中毒的风险人群。 方法：使用 PubMed、Scopus、Web of Science 和 Cochrane 图书馆对 2018 至 2023 年间描述对乙酰氨基酚过量的已发表病例报告进行了系统综述。此外，对同一时期捷克毒理学信息中心（TIC）的电话咨询进行了回顾性分析。 结果：68 篇已发表的病例报告符合纳入标准，报告剂量范围为 6.5 至 250 g。50 例（74%）为故意过量，其中包括 11 名少女（占故意过量病例的 22%）。该亚组中无死亡报告。2018 至 2023 年间，TIC 共记录 3,318 例与对乙酰氨基酚暴露相关的咨询，其中 2,032 例（61%）涉及故意过量。故意过量病例中女性占多数，尤其是在儿童和青少年中，并且 2020 年后 0-19 岁女孩的故意过量人数有所增加。数据表明，涉及对乙酰氨基酚的自杀企图数量在不断增长，尤其是在少女中。 结论：文献和国家毒理学数据中报告的大多数对乙酰氨基酚中毒均为故意行为，青少年女性是一个关键的风险人群。 需要关注对乙酰氨基酚相关风险的安全使用和沟通。
完整摘要 · 英文原文
OBJECTIVES: Paracetamol is widely used as an analgesic and antipyretic, but its accessibility also makes it a frequent drug in overdose cases. Increasing rates of intentional paracetamol poisoning, particularly among adolescents, raise public health concerns. This study aimed to examine recent patterns of paracetamol overdose and identify risk groups for intentional self-poisoning. METHODS: A systematic review of published case reports (2018-2023) describing paracetamol overdose was conducted using PubMed, Scopus, Web of Science, and the Cochrane Library. Additionally, a retrospective analysis of telephone inquiries to the Czech Toxicological Information Centre (TIC) during the same period was performed. RESULTS: Sixty-eight published case reports met inclusion criteria, with reported doses ranging from 6.5 to 250 g. Intentional overdose occurred in 50 cases (74%), including 11 teenage girls (22% of intentional cases). No deaths were reported in this subgroup. TIC recorded 3,318 inquiries related to paracetamol exposure between 2018 and 2023, of which 2,032 (61%) involved intentional overdose. Females predominated among intentional cases, particularly in children and adolescents, and the number of intentional overdoses among girls aged 0-19 years increased after 2020. The data indicate a growing number of suicide attempts involving paracetamol, particularly among teenage girls. CONCLUSION: The majority of paracetamol intoxications reported in the literature and in national toxicological data were intentional, with adolescent females representing a key risk group. Increased attention to the safe use and communication of paracetamol-related risks is needed.