影响有机磷中毒患者预后多因素分析

Multivariate Analysis of Prognostic Factors for Patients with Organophosphorus Pesticide Poisoning

目的探讨影响有机磷中毒患者的预后因素。方法随访120例口服有机磷中毒患者,在中毒24 h内统计年龄、有机磷农药口服量、胆碱酯酶指数、血液透析总时间、初次血液净化时间、血小板、白细胞、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、血糖、肌酐、初次用药时间、血钾等13项指标,采用Log-rank检验进行单因素分析,再将有显著差异的影响因素进行Cox比例风险模型多因素分析,检验各因素与有机磷中毒患者生存时间的关系。结果单因素分析结果显示13项指标均对患者预后有影响(P<0.05)。多因素分析结果表明口服量、胆碱酯酶、初次血液净化时间、初次用药时间这4个因素对有机磷患者生存时间的影响有统计学意义(P<0.05)。结论口服量、胆碱酯酶、初次血液净化时间、初次用药时间是影响有机磷患者预后的重要因素。

Objective To study the prognostic factors for organophosphorus pesticide poisoning patients. Methods 120 cases with organophosphorus pesticide poisoning were studied and 13 factors such as age, dose of organophosphorus pesticide, AchE, time of initial hemoperfusion, total time of hemoperfusion, WBC, PLT, ALT, AST, Scr, blood glucose level, time of using drugs initially and blood K ~ level were evaluated by Log-rank test. The significant factors were evaluated by Cox＇ s proportional hazard index analysis to locate the significant factors related to prognosis. Results 13 factors were all significant by Log-rank test（ P 〈 0.05 ）. Dose of organophosphorus pesticide, AchE, time of initial hemoperfusion and time of using drugs initially were significant factors by Cox ＇ s proportional hazard model （ P 〈 0.05 ）. Conclusion Dose of organophosphorus pesticide, time of initial hemoperfusion and time of using drugs initially are the four main factors.