摘要
目的探讨重度急性有机磷农药中毒(AOPP)患者N末端脑钠肽前体(NT-pmBNP)和血磷变化的临床意义。方法选取78例重度AOPP患者,分为死亡组(54例)和存活组(24例)。分别于入院时,入院1、2,4d后,转出ICU时或死亡前检测NT。pmBNP和血磷。结果两组入院时NT-proBNP和血磷比较差异无统计学意义(P〉0.05);入院1、2、4d后,死亡组NT-proBNP明显高于存活组[死亡组:(1986.5±24.9)、(3568.2±56.9)、(7829.0±64.3)ng/L;存活组:(1068.4±20.2)、(986.6±16.4)、(943.7±14.6)ng,L,P〈0.05或〈0.01],血磷明显低于存活组[死亡组:(1.22±0.13)、(0.81±0.10)、(0.58±0.07)mmol/L;存活组:(1.53±0.16)、(1.48±0.13)、(1.46±0.14)mmol/L,P〈0.05或〈0.01];且随着时间的延长,死亡组患者的NT-proBNP逐渐升高(P〈0.05),血磷逐渐降低(P〈0.05);存活组在转出ICU时NT-pmBNP较人院时明显降低[(327.5±12.3)ng/L比(1023.3±18.8)ng,L,P〈0.05];存活组各时间点血磷比较差异无统计学意义(P〉O.05);死亡组死亡前NT.pmBNP明显高于存活组转出ICU时[(31486.5±120.7)ng,L比(327.5±12.3)ng/L,P〈0.01],血磷明显低于存活组转出ICU时[(0.24±0.03)mmol/L比(1.57±0.15)mmol/L,P〈0.01].结论重度AOPP患者随着病情的进展,N^pmBNP逐渐升高,血磷逐渐降低,N%pmBNP和血磷是反映重度AOPP患者预后指标。
Objective To observe the change of blood phosphorus and N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with severe acute organophosphorus pesticide poisoning (AOPP) and explore their clinical significance. Methods Seventy-eight severe AOPP patients were selected and divided into dead group (54 cases) and survival group (24 cases). NT-proBNP and blood phosphorus were examined when the patients were just hospitalized, and after 1, 2, 4 d and when they were turn out from ICU or before the patients dead. Results Comparing with survival group, blood phosphorus and NT-proBNP of dead group had no significant difference when the patients were just hospitalized(P〉 0.05). After 1, 2 and 4 d NT-proBNP of dead group [(1986.5 ±24.9), (3568.2 ± 56.9), (7829.0 ±64.3) ng/L] was higher than that of survival group [ ( 1068.4 ± 20.2), (986.6 ± 16.4), (943.7 ±14.6) ng/L, P 〈 0.05 or 〈 0.01 ], while blood phosphorus was significant lower than that in survival group [ ( 1.22 + 0.13 ), (0.81 ±0.10), (0.58 s- 0.07 ) mmol/L vs. ( 1.53 ± 0.16), ( 1.48 ± 0.13 ), ( 1.46 ± 0.14) mmol/L, P 〈 0.05 or 〈 0.01 ]. NT-proBNP of dead group increased and blood phosphorus reduced gradually by time extending (P 〈 0.05). NT-proBNP was lower when patients were turn out from ICU than that when the patients were just hospitalized [ (327.5 ± 12.3 ) ng/L vs. (1023.3± 18.8) ng/L, P 〈 0.05 ]. Blood phosphorus had no difference at all time points in survival group (P〉 0.05). NT-proBNP was higher [(31 486.5 ± 120.7) ng/L vs.(327.5 ± 12.3) ng/L,P〈 0.01 ] and blood phosphorus was lower [ (0.24 ± 0.03 ) mmol/L vs. ( 1.57 ±0.15 ) mmol/L,P 〈 0.01 ] before death in dead group compared with those at the time turning out from ICU in survival group. Conclusions The value of NT-proBNP increased and blood phosphorus reduced gradually with disease prograssion. NT-proBNP and blood phosphorus were important factors reflecting the prognosis of blood AOPP patients.
出处
《中国医师进修杂志》
2012年第12期9-12,共4页
Chinese Journal of Postgraduates of Medicine
关键词
有机磷化合物
中毒
利钠肽
脑
磷
Organophosphoruscompounds
Poisoning
Natriureticpepfide,brain
Phosphorus