急性百草枯中毒237例临床分析

Clinical analysis of 237 patients with acute paraquat poisoning

回顾性分析山东省立医院 2010年4月-2012年11月收治的237例非生产性百草枯中毒患者的临床资料,其中男性122例,女性115例,年龄 11-83岁,平均 34.9岁.存活97例,死亡140例,病死率 59.1%.入院时尿连二亚硫酸钠试验结果为淡蓝色的全部患者存活,结果为深蓝色患者的病亡率达84.2%（128/152）.尿百草枯浓度与中毒严重程度呈显著正相关,相关系数为0.720（P＜0.01）.服药量受试者工作特征曲线下面积为 0.887 （0.845-0.928）,在最佳截断点为36.5 ml时,预测死亡的敏感性为81.4%,特异性为80.2%.表明尿连二亚硫酸钠试验是判断急性百草枯中毒病情和预后的可靠指标.

The clinical data of 237 suicidal patients with acute paraquat poisoning from April 2010 1o November 2012 were retrospectively analyzed. There were 122 males and 115 females with a mean age of 34. 9 （ 11 - 83 ） years. The crude 60-day mortality was 59. 1% （140/237）. All patients with trace or clear blue results in their urine dithionite tests survived and 128/152 （84. 2% ） patients with dark blue results in their urine dithionite tests deceased. A significant correlation existed between urine paraquat concentrations and degrees of severity for paraquat poisoning following ingestion （Spearman correlation 0. 720, P 〈 0. 01 ）. The receiver operating characteristics area under the curve of the amount ingested was 0. 887 （0. 845 - 0. 928 ）. Under a cutoff value of 36.5 ml,the amount ingested had a sensitivity of 81.4% and a specificity of 80. 2% in predicting mortality. The prognosis of patients with paraquat poisoning was closely related with theamount ingested. And urine dithionite test might be a reliable indicator of the severity and prognosis of acute paraquat poisoning.