摘要
目的探讨有机磷中毒呼吸衰竭的危险因素及早期监测血降钙素原(PCT)水平的意义。方法回顾性分析2015年7月-2017年7月于我院就诊的50例有机磷中毒患者资料,按是否合并呼吸衰竭分为21例呼吸衰竭组及29例非呼吸衰竭组,对两组临床资料进行分析,明确并发呼吸衰竭的可能危险因素,并选用受试者工作绘制特征(ROC)曲线分析PCT预测呼吸衰竭的效能。结果单因素分析可见,两组APACHEⅡ评分、中毒至救诊时间、血乳酸、胆碱酯酶、呼吸机相关性肺炎、屈颈抬头无力和PCT比较有统计学差异(P<0. 05);多因素分析可见,APACHEⅡ评分、中毒至救诊时间、血乳酸、胆碱酯酶、呼吸机相关性肺炎、屈颈抬头无力和PCT为有机磷中毒呼吸衰竭的独立危险因素(P <0. 05)。PCT曲线下面积为0. 784,敏感度89. 70%、特异度为72. 00%,阳性预测值为57. 14%、阴性预测值为75. 86%。结论 APACHEⅡ评分、中毒至救诊时间、胆碱酯酶、血乳酸、呼吸机相关性肺炎、屈颈抬头无力、PCT为有机磷中毒呼吸衰竭的危险因素,其中血PCT为有机磷中毒呼吸衰竭的重要诊断指标,临床应加强对以上指标的重视程度,以更好的指导临床治疗。
Objective To investigate the clinical significance of the risk factors with organic phosphorus poisoning respiratory failure and early monitoring of blood procalcitonin （PCT） level. Methods 50 patients with organophosphorus poisoning who received therapy from July 2015 to July 2017 in our hospital were divided into the respiratory failure group （n = 21 ） and the non-respiratory failure group （n = 29 ）, according to whether the combination of respiratory failure. Their clinical data was analyzed to clear possible risk factors complicated with respiratory failure. Receiver operating characteristic （ROC） curve was used to analyze the efficacy of PCT in predicting respiratory failure. Results Single factor analysis showed there were significant differences in APACHE Ⅱ score, poisoning to save diagnostic time, blood lactic acid, cholinesterase, ventilator associated pneumonia, cervical up weakness and PCT between the two groups （P 〈 0. 05）. Multi-factor analysis showed that APACHE Ⅱ score, poisoning to save diagnostic time, blood lactic acid, cholinesterase, ventilator associated pneumonia, flexor neck weakness and PCT were independent risk factors for organophosphate poisoning respiratory failure （ P 〈 0. 05 ）. The area under PCT curve was 0. 784, with 89. 7% of sensitivity, 72% of specificity, 57.14% of positive predictive value and 75.86% of negative predictive value. Conclusion The risk factors for organophosphate poisoning respiratory failure include APACHE Ⅱ score, poisoning to save diagnostic time, cholinesterase, blood lactic acid, ventilator associated pneumonia, cervical rise weakness, and PCT, which should be strengthened to guide clinical treatment.
作者
黄永禄
王玉兰
HUANG Yong-lu;FANG Yu-lan(Emergency Department,the Second People＇s Hospital of Liaoeheng,Liaoeheng,Shandong 252600,China)
出处
《临床肺科杂志》
2018年第11期2087-2090,共4页
Journal of Clinical Pulmonary Medicine
