BNP联合PCT测定对有机磷农药中毒患者监控的临床价值

Clinical value of BNP combined with PCT determination in monitoring of organic phosphorus pesticide poisoning patients

目的研究B型利钠肽(BNP)联合降钙素原(PCT)测定对有机磷农药中毒患者监控的临床价值。方法 50例有机磷农药中毒患者,给予所有患者行催吐、洗胃、导泻、气管插管、机械通气、抗感染等常规对症处理,对患者进行血浆BNP和血浆PCT连续监测的数据改变情况及病情变化进行比较,分析BNP与PCT测定在有机磷农药中毒患者中的数据变化与患者疾病转归的关联性。结果通过对患者监测BNP及PCT,50例中毒患者中有34例患者BNP测定结果持续增高(A组),其PCT结果亦升高,提示BNP升高患者细菌感染情况相对较普遍,平均住院时间为(15.0±2.1)d;16例患者BNP一过性升高(B组),PCT结果低于A组,住院时间为(9.0±1.3)d短于A组,差异有统计学意义(P<0.05)。主动服用的患者BNP及PCT指标高于误服或呼吸道吸入患者,治疗时间多于误服或呼吸道吸入患者,差异有统计学意义(P<0.05)。结论 BNP联合PCT测定对有机磷农药中毒患者临床诊疗有积极意义,有机磷农药中毒患者存在不同程度的心肌损伤及细菌感染状态。

Objective To study the clinical value of B-type natriuretic peptide（BNP） combined with procalcitonin（PCT） determination in monitoring of organic phosphorus pesticide poisoning patients. Methods A total of 50 organic phosphorus pesticide poisoning patients all received conventional symptomatic treatment of vomiting, gastric lavage, catharsis, tracheal intubation, mechanical ventilation and anti-infection. Comparison were made on data changes in continuous monitoring plasma BNP and plasma PCT, and correlation between data changes of BNP and PCT determination in organic phosphorus pesticide poisoning patients and prognosis of disease. Results Through monitoring BNP and PCT in patients, 34 patients（group A） had continuous increased BNP determination results in 50 poisoning patients, and their PCT result also increased, which suggested that bacterial infection in patients with increased BNP was relatively common, with average hospital stay time as（15.0±2.1） d. 16 patients had transient rise of BNP（group B）, and their PCT result was lower than group A, with average hospital stay time as（9.0±1.3） d, which was shorter than group A, and the difference had statistical significance（P0.05）. Initiative taking patients had higher BNP and PCT index than the mistaking or respiratory inhalation patients, and more treatment days than the mistaking or respiratory inhalation patients, and the difference had statistical significance（P0.05）. Conclusion Combination of BNP and PCT determination shows positive significance for clinical diagnosis and treatment in patients with organic phosphorus pesticide poisoning, and there are different degrees of myocardial injury and bacterial infection in organic phosphorus pesticide poisoning patients.