早期白细胞计数及中性粒细胞比率变化对急性百草枯中毒的预后分析

Prognosis analysis of acute paraquat poisoning with early changes of white blood cells and neutrophils ratio

目的 探讨急性百草枯中毒早期白细胞计数及中性粒细胞比率变化与预后的关系.方法 选取急性百草枯中毒患者954例进行回顾性分析,根据预后分为生存组和死亡组,监测百草枯中毒24 h内外周血白细胞及中性粒细胞比率变化,分析生存组和死亡组白细胞计数及中性粒细胞比率的变化.结果 954例急性百草枯中毒患者中,410例生存,544例死亡,病死率为57.0%.与存活组比较,死亡组白细胞计数[（19.22±8.37）×10^9/L比（11.46±4.55）×10^9/L,P=0.001]及中性粒细胞比率[（92.98±3.02）%比（85.31±9.02）%,P=0.000]均明显升高,差异有统计学意义（P〈0.05）.ROC曲线显示,早期白细胞计数及中性粒细胞比率预测百草枯中毒死亡价值较大.血白细胞计数的ROC曲线下面积为0.813,敏感度为0.784,特异度为0.714;中性粒细胞比率的ROC曲线下面积为0.846,敏感度为0.831,特异度为0.718.结论 急性百草枯中毒患者早期外周血白细胞计数及中性粒细胞比率可作为预测预后的指标.

Objective To investigate the correlation between the early changes of white blood cell count, neutrophil ratio and prognosis of patients with acute paraquat poisoning.Methods Nine hundred and fifty-four patients with acute paraquat poisoning were divided into survival group and death group according to prognosis.The early changes of white blood cell count and neutrophil ratio within 24 hours were observed, the correlation between the early changes of white blood cell count, neutrophil ratio and prognosis of patients with acute paraquat poisoning were analyzed.Results Of the 954 cases, 410 cases were survival, 544 cases were died, the mortality rate was 57.0%.Compared with the survival group, the white blood cell count [（19.22±8.37）×109/L vs （11.46±4.55）×10^9/L,P=0.001] and the neutrophils ratio [（92.98±3.02）% vs （85.31±9.02）%,P=0.000] in death group were significantly increased, the differences were statistically significant（P〈0.05）.Area under the curve（AUC） of white blood cell count was 0.813, sensitivity was 78.4%, specificity was 71.4%.AUC of neutrophils ratio was 0.846, sensitivity was 83.1%, specificity was 71.8%.AUC of the ROC showed that white blood cell count and neutrophil ratio can predict the prognosis of patients with acute paraquat poisoning.Conclusions Early white blood cell count and neutrophil ratio can be used to predict the prognosis of patients with acute paraquat poisoning.