摘要
目的对可能影响急性百草枯中毒患者预后的早期因素进行相关性分析，为早期评估病情的危重程度、判断中毒患者预后及临床治疗方案调整提供依据，降低病死率。方法选取2011—12—2014—12于河北医科大学第二医院急诊科就诊的272例急性百草枯中毒患者，中毒距就诊时间均为24h之内。人院1h内对患者地区、性别、年龄、服毒量、饮酒与否进行登记，并抽血检测毒物浓度、血常规、生化、凝血等，登记毒检浓度、白细胞计数、肌酸激酶同工酶（CK—MB）、乳酸脱氢酶（LDH）、谷丙转氨酶（ALT）、门冬氨酸氨基转移酶（AST）、血钾、阴离子间隙、静脉血CO2、肌酐、尿素氮、血糖、血淀粉酶、白蛋白、血钠、血钙、血浆凝血酶原时间（盯）、活化部分凝血活酶时间（APTT）等，30天随访预后情况，根据预后分为存活组和死亡组。应用统计学单因素分析和多因素分析，比较患者预后与上述指标问的相互关系，并对独立指标建立ROC生存曲线，评价各指标对死亡的预测意义。结果百草枯中毒患者存活组和死亡组比较，饮酒与否、服毒量、毒检浓度、白细胞计数、CK—MB、LDH、ALT、AST、血钾、阴离子间隙、静脉血CO2、肌酐、尿素氮、血糖、血淀粉酶等15因素差异有统计学意义（P〈0．05），性别、白蛋白、血钠、血钙、PT、APTT等6个因素差异无统计学意义（P〉0．05）。结论服毒量、毒检浓度、饮酒与否、白细胞计数、CK—MB、ALT、血钾、肌酐、血糖为影响急性百草枯中毒早期预后的独立危险因素。
Objective This investigation will analyze the early factors that affect the prognosis of acute paraquat poisoning, and provide basis for clinical treatment plan adjustment, in order to reduce the mortality rate and the financial burden of paraquat poisoning patients. Methods Between December 2011 to December 2014, 272 patients with paraquat poisoning were selected from the Department of Emergency Medicine of Second Hospital of Hebei Medical University. We registered the gender, age, taking poison quantity, drinking or not, poison-concentration, and detected WBC, CK-MB, LDH, ALT, AST, potassium, AG, CO2, Cr, BUN, GLU, AMY, ALB, Na, Ca, T, APTF, etc within 1 hour after admission. Ac- cording to the prognosis within 30 days, they were divided into two groups, survival group and death group. Statistical analysis was carried out by two steps： the single factor and multiple factors analysis. Relationship between these indexes and the prognosis of patients was tested by binary logistic regression analysis step by step back （Backward： LR）. The result was different significantly if P 〈 0.05. Results For patients with paraquat poisoning, there were statistical differences in drink status, taking poison quantity, WBC, CK-MB, LDH, ALT, AST, K＋, AG, CO2, Cr, BUN, GLU, AMY （P 〈 0.05） between survival group and death group. However, gender, ALB, Na＋, Ca2＋, PT, APTT, had no statistical differences （P 〉 0.05）. The Logistic regression analysis indicated that the taking poison quantity, poison concentration, drink status, WBC, CK-MB, ALT, K＋, Cr, Glu are independent risk factors of early prognosis of acute paraquat poisoning （P 〈 0.05）. Conclusion There are statistical differences in drink status, taking poison quantity, poison, WBC, CK-MB, LDH, ALT, AST, K＋, AG, CO2, Cr, BUN, GLU, AMY in survival group and death group for patients with paraquat poisoning. The taking poison quantity, poison concentration, drink or not, WBC, CK-MB, ALT, K＋, Cr, Glu are independent risk factors of early prognos
出处
《中国急救医学》
CAS
CSCD
北大核心
2017年第4期352-358,F0003,共8页
Chinese Journal of Critical Care Medicine
关键词
百草枯中毒
预后
LOGISTIC回归分析
白细胞计数
服毒量
Acute paraquat poisoning
Prognosis
Logistic regression analysis
White blood cell count
Taking poison quantity
