血清学指标对百草枯中毒早期肺损伤的预测价值

Prediction value of serum indexes of early lung injury in patients with acute paraquat poisoning

目的探讨百草枯中毒急性肺损伤(ALI)发生时间与血清学指标之间的关系,为预测早期发生肺损伤提供参考。方法选取2014年1月1日至2016年1月1日收治的百草枯中毒患者107名,根据肺部有无损伤及入院后损伤的时间(7 d为界限)分为无肺损伤组、早期肺损伤组和晚期肺损伤组,分析患者年龄、性别、入院后24 h内的尿素(BUN)、肌酐(Cr)、淀粉酶(AMY)、C反应蛋白(CRP)、心肌激酶(CK)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)和丙氨酸氨基转移酶(ALT)检测结果。结果肾功能指标(血BUN、Cr)、CRP和AMY结果在无ALI组、晚ALI组到早ALI组,依次递增,且皆有统计学意义(P<0.05)。AST、CK、LDH和ALT在无ALI组和晚ALI组差异无统计学意义(P<0.05),而在早ALI组明显高于晚ALI组,差异有统计学意义(P<0.05)。结论肾功能、CRP、AMY、心肌酶在早ALI组明显高于其他组,可作为预测早期发生肺损伤的指标。

Objective To investigate the relationship between the time of occurrence of acute lung injury（ALI） and serum indexes in paraquat poisoning,and provide reference for predicting the occurrence of lung injury in early stage.Methods 107 cases of acute paraquat poisoning patients were selected from The Twelfth People′s Hospital of Guangzhou during January 1,2014 to January 1,2016. These cases were divided into no pulmonary injury group,early lung injury group and late lung injury group according to pulmonary damage and the time of injury（seven days as the boundary）. The patients′ age,sex,the relevant serological test results within 24 hours were retrospectively analyzed. Results The renal function indexes（BUN and Cr）,CRP level and AMY level showed an ascending levels in the without ALI group,late ALI group and early ALI group. The levels of AST,CK,LDH and ALT of the early ALI group were significantly higher than those of late ALI group（P〈0.05）,but had no significant difference between the late ALI group and without ALI group.Conclusion Renal function,CRP level and AMY level,myocardial enzyme level in the early ALI group were significantlyhigher than those of the other groups,and could be used as a predictor of early lung injury.