动态监测血清胰石蛋白水平对急性百草枯中毒患者预后的预测价值

The Predictive Value of Dynamic Monitoring Serum Pancreatic Stone Protein Levelfor the Prognosis of Patients with Acute Paraquat Poisoning

目的探讨动态监测血清胰石蛋白(PSP)水平对急性百草枯中毒(APP)患者预后的预测价值。方法157例APP患者根据28d预后情况分为存活组(74例)和死亡组(83例)。采用酶联免疫吸附法(ELISA)分别检测所有两组患者入院后第1、3、7d血清PSP、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)表达水平。比较两组患者入院后不同时间点PSP、PCT、TNF-α、CRP表达水平,分析各观察指标与APP患者28d死亡事件的相关性,分析血清PSP表达水平对患者预后的预测价值。结果死亡组患者入院后第1、3、7dPSP、PCT、TNF-α、CRP表达水平均明显高于存活组(P<0.05),入院第3dPSP、PCT、TNF-α、CRP表达水平较入院第1d均明显升高(P<0.05),而入院第7dPSP、PCT、TNF-α、CRP表达水平较入院第1、3d均明显降低(P<0.05);入院后第1、3、7d血清PSP、PCT、TNF-α、CRP表达水平与APP患者28d死亡事件均呈正相关性关系,但血清PSP与APP患者28d死亡事件的相关性系数更高于血清PCT、TNF-α、CRP。入院后第1、3、7d血清PSPROC曲线下面积(AUC)分别为0.72、0.77、0.82。结论动态监测血清PSP水平对APP患者预后具有较高的预测价值,可作为预测APP患者预后的新型实验室标志物。

Objective To evaluate the predictive value of dynamic monitoring serum pancreatic stone protein(PSP)level for the prognosis of patients with acute paraquat poisoning(APP).Methods 157 APP patients were divided into the survival group(74 cases)and the death group(83 cases)according to the 28-day prognosis.The serum levels of PSP,PCT,TNF-α and C-reactive protein(CRP)of all patients on the 1st,3rd and 7th day after admission were detected by enzyme-linked immunosorbent assay(ELISA).The expression levels of PSP,PCT,TNF-α and CRP of the two groups at different time points after admission were compared,and the correlation between the observed indexes and the 28-day mortality of APP patients,predictive value of serum PSP level for the prognosis of patients were all analyzed.Results The expression levels of PSP,PCT,TNF-α and CRP in the death group were significantly higher than those in the survival group on the 1st,3rd and 7th day after admission( P <0.05).The expression levels of PSP,PCT,TNF-α and CRP in the 3rd day after admission were significantly higher than those in the 1st day after admission( P < 0.05 ),while the expression levels of PSP,PCT,TNF-α and CRP on the 7th day after admission were significantly lower than those on the 1st,3rd after admission( P < 0.05 ).The expressions of PSP,PCT,TNF-α,and CRP on the 1st,3rd and 7th day after admission were all positively correlated with the 28-day mortality of APP patients,but the correlation coefficient of serum PSP and 28d death in patients with APP was higher than that of serum PCT,TNF-α,CRP.The ROC area under curve(AUC)of the PSP on the 1st,3rd and 7th day after admission were 0.72,0.77 and 0.82 respectively.Conclusion Dynamic monitoring of serum PSP level has a high predictive value for the prognosis of APP patients,and can be used as a new laboratory marker to predict the prognosis of APP patients.