百草枯中毒患者实验室检测结果变化与病情进展的关系

Connection between changes of laboratory results and the progess of disease in patients with paraquat poisoning

目的研究百草枯(PQ)中毒致急性肺损伤患者实验室各检测结果与病情进展的关系。方法将37例PQ中毒致急性肺损伤患者分为生存组和死亡组,回顾性分析两组患者入院第1天、第3天、出院前的WBC计数、超敏C-反应蛋白(hs-CRP)、肝功能、肾功能、心肌酶学等检测结果。另选20名健康体检者作为对照组。结果生存组第1天的WBC、丙氨酸氨基转移酶(ALT)、肌酸激酶同工酶(CK-MB)水平显著高于对照组(P<0.01),第3天的WBC、ALT、总胆红素(TBiL)、尿素氮(BUN)、肌酐(Cr)水平高于第1天(P<0.01),出院前除ALT外各指标水平与对照组比较,差异无统计学意义(P>0.05)。死亡组各指标水平均显著高于生存组(P<0.01),除WBC外,各指标水平随时间呈上升趋势,且与前1次测量值比较,差异有统计学意义(P<0.01)。结论 PQ致急性肺损伤患者的肝功能最易受损,随病情进展易发生波动。入院第1天hs-CRP明显升高及第3天肝、肾、心肌功能指标若至少有两项明显升高的患者,其临床转归较差。

Objective To study the correction between changes of laboratory results and the progess of disease in pa- tients with acute lung injury caused by paraquat poisoning. Methods 37 patients with acute lung injury caused by paraquat poisoning were divided into the survival group and the death group.WBC,high sensitivity C-reactlve protein, liver function,kidney function,myocardial enzymology and other detection results in the survival group and the death group were analyzed retrospectively.20 healthy subjects were selected as the control group. Results In the survival group,the level of WBC,ALT and CK-MB in the first day were higher than those in the control group （P〈0.01）,in the third day,the level of WBC,ALT,TBiL,BUN and Cr in the survival group were higher than those in the first day （P〈0.01） and there was no statistical difference of all parameters except ALT between the survival group before discharge and the control group （P〉0.05）.In the death group,the level of all parameters were much higher than those in the survival group （P〈0.01） and all parameters （in addition to WBC） showed an upward tendency with time and there was a statisti- cal difference compared with the previous measurements （P〈0.01）. Conclusion For patients with acute lung injury caused by paraquat poisoning,their liver function is easily damaged and prone to fluctuates with the progress of the dis- ease.For patients with hs-CRP increased obviously in the first day,and with liver,kidney,and cardiac function index （if at least two obviously increasing） and their clinical outcome is poorer.