超敏C反应蛋白与急性有机磷农药中毒多脏器功能障碍的相关性分析

Correlation of high sensitivity C-reactive protein and acute organophosphrus pesticide poison with multiple organ dysfunction

目的探讨急性有机磷农药中毒(AOPP)患者血清高敏C反应蛋白(hsCRP)与各脏器损伤的相关关系。方法多脏器功能障碍综合征(MODS)死亡组8例,MODS非死亡组23例,对照组30例,分别测定血清hsCRP、血常规、血生化、心肌酶学等指标,比较组间差异,分析hsCRP与各指标的相关性。结果对照组、MODS非死亡组、MODS死亡组间,胆碱脂酶(ACHE)水平(8.07±2.19)kU/L、(0.60±0.19)kU/L vs(0.40±0.21)kU/L依次降低(P<0.01);hsCRP水平(1.47±0.54)mg/L vs(19.02±5.61)mg/L、(58.44±40.30)mg/L、白细胞(WBC)水平(6.45±1.58)×109/L vs(13.95±3.62)×109/L、(18.57±10.57)×109/L、中性粒细胞(N)水平(3.66±1.21)×109/L vs(11.01±6.05)×109/L、(13.19±7.54)×109/L、血小板(PLT)水平(201.17±81.03)×109/L vs(325.04±110.91)×109/L、(407.54±132.78)×109/L均依次升高(P<0.01);3组间红细胞(RBC)和血红蛋白(Hb)差异无统计学意义(P>0.05);乳酸脱氢酶(LDH)水平193.00(32.75)U/L vs 285.00(168.00)U/L、583.50(680.00)U/L;空腹血糖(FPG)水平5.26(0.69)mmol/L vs 8.76(5.75)mmol/L、12.83(11.01)mmol/L依次升高(P<0.01);MODS死亡组天冬氨酸转氨酶(AST)72.00(478.00)U/L、尿素氮(BUN)10.25(11.30)mmol/L、肌酸激酶(CK)416.50(1 221.70)U/L、血肌酐(SCr)140.00(196.00)μmol/L均高于健康对照组(P<0.01);MODS死亡组和非死亡组肌酸激酶同工酶(CK-MB)35.75(121.65)U/L、33.00(49.00)U/L均高于对照组(P<0.01)。hsCRP与ACHE成负相关,与PLT、RBC和Hb间无相关关系,与WBC、N、CK-MB、LDH、丙氨酸转氨酶(ALT)、AST、FPG、BUN、CK、SCr间呈正相关关系。结论 HsCRP对AOPP中毒的程度及其预后的判断均有临床指导意义。

Objective To investigate the correlation between serum high sensitivity C-reactive protein （hsCRP） with the degree of organ damage of patients with acute organophosphrus pesticide poison （AOPP）. Methods 31 cases of AOPP patients with multiple organ dysfunction syndrome（MODS） and 30 control cases were enrolled, the serum levels of hsCRP, blood cell count, blood chemistry, serum creatine kinase and other indicators were determined to compare differences between two groups and analyze the correlation between hsCRP with the other indicators. Results Acetylcholine esterase（ACHE） levels between the healthy control group,MODS non-death group, MODS death group （8. 07522.19） kU/L,（0. 60520.19） kU/L vs （0. 40520.21） kU/L,were decreased,and the difference was statistically significant （ P 〈0, 01） ; hsCRP levels （1. 47520.54） mg/L vs （19. 02525.61） mg/L, （58.44±40.30） mg/L,WBC （6.45± 1.58） × 10^9/L vs （13.95±3.62） × 10^9/L, （18.57±10.57） ×10^9/L, neutrophil （3.66 ± 1.21） × 10^9/L vs （11. 01±6.05）×10^9/L,（13.19±7.54）×10^9/L, PLTlevel （201.17±81.03） ×10^9/Lvs （325.04±10.91）×10^9/L, （407. 54±132.78）× 10^9/L increased successively, the difference was statistically significant （ P 〈0.01） ; three groups showed no statistically significantce in RBC and Hb（ P 〉0.05） ; LDH level 193.00（32.75） U/L vs 285.00（168.00） U/L,583.50（680.00） U/L; FPG level 5.26（0.69） mmol/L vs 8.76（5.75） mmol/L,12. 83（11. 01） mmol/L increased successively,the difference was statistically significant （ P 〈0.01）; in MODS death group,AST 72.00（478.00） U/L, BUN 10.25（11.30） mmol/L,CK 416.50（1 221.70） U/L,SCr 140.00（196.00） tlmol/L were higher than those in the healthy control group, the difference was statistically significant （ P 〈0.01）; in MODS death group and non-death group,CK-MB 35.75（121.65） U/L,33.00（49.00） U/L were higher than that in healthy control group,the difference was statistically significant （ P 〈0.01）. Conclusion HsCRP has clinical significance to judge the degrees of poisoning of AOPP and prognosis.