제초제 Paraquat 중독환자에서 vitamin C 투여가 plasma total antioxidant capacity에 미치는 영향

• Published in: The Korean journal of medicine Vol. 58; no. 6; pp. 666 - 674
• Main Authors: 홍세용, Sae Yong Hong, 은수훈, Soo whon Eun, 한찬희, Chan Hee Han, 윤영근, Yung Kun Yoon, 양동호, Dong Ho Yang, 조성란, Suk Ran Cho, 김휘준, Whi Jun Kim, 한찬수, Chan Soo Han, 박영현, Yung Hyun Park
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.06.2000
• Subjects: Ascorbic acid; Free radical scavengers; Paraquat; Pulmonary fibrosis
• ISSN: 1738-9364

Background : This study was undertaken to evaluate the effect of plasma concentration of vitamin C is on the plasma total antioxidant status(TAS) in patients with paraquat intoxication. Methods : As a preliminary research for this study, we measured plasma vitamin C levels, uric acid, TAS, and bilirubin from 100 healthy Koreans aged between 25-55 years. Various concentrations of vitamin C were constructed in vitro with normal pooled plasma between 1mg/dl and 100 mg/dL and TAS was measured. Both vitamin C concentrations and TAS were measured from the blood samples, taken at 0.5, 1, 2, 3, 5, 7, 9 hours after a bolus injection of vitamin C(50 mg/kg) from 7 volunteers who had been recruited from medical students at our hospital. Various amounts of vitamin C were given to 10 patients with paraquat intoxication for 5 consecutive days in the morning : first day ; 100 mg single dose, second day; 500 mg single dose, third day ; 1,000 mg single dose, fourth day : 3,000 mg single dose, and fifth day ; 3,000 mg three times every 8 hours. Results : The mean value of TAS and vitamin C measured in 100 healthy Korean adults was 2.22 ±0.16 mmol/L and 0.48±0.10 mg/dL. Age and sex do not influence these levels(p>0.05, data are not presented). A direct correlation was observed between TAS and vitamin C concentrations of 1 mg/dL and 100 mg/dL both in vivo and vitro. As the vitamin C concentration was increased gradually 5 consecutive days, the TAS values increased in the same way as follows : first day(vitamin C 100 mg) 2.26±0.98 mmol/L, second day(vitamin C 500 mg) 2.76±0.78 mmol/L, third day(vitamin C 1.000 mg) 2.81±0.68 mmol/L, fourth day(vitamin C 3.000 mg) 3.18 mmol/L. On the fifth day when 3.000 mg of vitamin C was given by bolus intravenous injection 3 times(every 8 hours for a day), the TAS values measured one hour after the injection was 3.58±0.37 mmol/L. Conclusion : When vitamin C is used as a free radical scavenger, the loading dose and maintenance dose should be around 2278 mg intravenous bolus and 146 mg/hour. High doses of vitamin C are effective and safe for patients with acute paraquat intoxication.(Korean J Med 58:666-674, 2000)