早期动脉血碱剩余、二氧化碳分压对急性百草枯中毒患者预后的预测价值

Early base excess and arterial carbon dioxide partial pressure monitoring in predicting the outcome of patients with acute paraquat poisoning

目的探讨早期动脉血碱剩余(BE)、二氧化碳分压(PaCO2)对急性百草枯中毒患者预后的预测价值。方法采用回顾性分析方法,选取2007年1月～2012年9月我院救治的67例急性百草枯中毒患者为研究对象。根据入院后30 d时结局,将口服百草枯患者分为存活组和死亡组。比较两组入院时动脉血碱剩余、PaCO2的差异,高低碱剩余组、高低PaCO2组早期病死率的差异,并分析其对患者预后的预测价值。结果低PaCO2组30 d病死率、乳酸值高于高PaCO2组,BE水平明显低于高PaCO2组。低BE组30 d病死率、入院时乳酸值高于高BE组,入院时PaCO2水平明显低于高BE组(P<0.05)。急性口服百草枯中毒患者就诊时BE、PaCO2、乳酸和入院12 h BE预测30 d病死率的ROC曲线下面积分别为0.856、0.675、0.836、0.912。结论早期碱剩余、PaCO2是早期评估急性百草枯中毒患者预后的良好指标。

Objective To explore the the prognostic value of early arterial base excess （BE）and carbon dioxide partial pressure （PaCO2） for the outcome of patients with acute paraquat poisoning. Methods Using a retrospective analysis method, 67 patients with acute paraquat intoxication from January 2007 to September 2012 were included according to the 30 day after admission outcomes. The oral administration of paraquat were divided into survival group, and death group. The groups were compared on admission arterial blood BE and the difference of the PaCO2, the early mortality in high BE group and low BE group were calculated,and the analysis of its prognostic value. Results Low PaCO2 group 30 d mortality, lactate values higher than the high PaCO2 group. Low BE group 30 d mortality, admission lactate values higher than the high BE group, PaCO2 levels were significantly lower than those on the high BE group, The area under the ROC curve of BE and PaCO2 on admission and the minimum BE within12h after admission were 0.856, 0.675 and 0.912（P 〈 0.05）,respectively. Conclusion Early base excess, PaCO2 is an early assessment of acute paraquat poisoning patients prognosis.