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Amatoxin 중독 환자에서 Silymarin, Penicillin, N-acetylcysteine의 효과 비교: 체계적 고찰

Other Titles
 Comparison of Silymarin, Penicillin, N-acetylcysteine in Patient with Amatoxin Poisoning: A Systematic Review 
 최민우  ;  고동률  ;  공태영  ;  좌민홍  ;  유제성  ;  정성필 
 Journal of the Korean Society of Clinical Toxicology (대한임상독성학회지), Vol.16(1) : 33-41, 2018 
Journal Title
 Journal of the Korean Society of Clinical Toxicology (대한임상독성학회지) 
Issue Date
Amatoxin ; Poisoning ; Silymarin ; Silibinin ; Penicillin ; Acetylcysteine
Purpose: This study was conducted to evaluate the clinical efficacy of pharmacologic treatment of amatoxin poisoning patients. Methods: Literature was accessed through PubMed, EMBASE, Cochrane library, KoreaMed, KISS and KMBASE. Studies relevant to human use of pharmacologic therapy including silymarin, penicillin and N-acetylcysteine (NAC) for amanita poisoning were included. Case reports, letters, editorials and papers with insufficient information were excluded. Comparison of clinical outcomes (especially mortality and liver transplantation rate) in each study was analyzed. Results: The final analysis included 13 retrospective studies. None of these studies showed direct comparisons of individual agents. Among 12 studies comparing silymarin vs penicillin, eight showed clinical superiority of silymarin. Among eight studies comparing silymarin with NAC, six showed clinical superiority of silymarin. Among seven studies of NAC vs penicillin, five showed clinical superiority of NAC. Conclusion: This systematic review suggested that clinical superiority of various pharmacological agents used to treat amatoxin poisoning is debatable. Nevertheless, the available evidence suggests it is reasonable to consider combinations of multiple agents for patients with amanita poisoning. Further studies are required to establish a treatment regimen for amanita poisoning.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
고동률(Ko, Dong Ryul) ORCID logo https://orcid.org/0000-0002-3098-2784
공태영(Kong, Tae Young) ORCID logo https://orcid.org/0000-0002-4182-7245
유제성(You, Je Sung) ORCID logo https://orcid.org/0000-0002-2074-6745
정성필(Chung, Sung Pil) ORCID logo https://orcid.org/0000-0002-3074-011X
좌민홍(Choa, Min Hong) ORCID logo https://orcid.org/0000-0003-0338-994X
최민우(Choi, Min Woo) ORCID logo https://orcid.org/0000-0002-0398-6835
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