急性百草枯中毒的预后因素分析

Analysis of Prognostic Factors of Acute Paraquat Poisoning

目的分析急性百草枯中毒(APP)预后的影响因素,探讨提高APP患者生存率的方法。方法回顾性分析2013年6月-2018年7月收治的235例APP患者的临床资料,按结局分为生存组及死亡组,比较两组患者临床特征、实验室检验指标差异,并进行单因素及多因素分析、生存曲线分析。结果 235例患者死亡率40.5%,平均生存时间为22.35 d,单因素分析显示:服毒剂量、入院血糖值、丙氨酸氨基转移酶(AST)、白细胞(WBC)差异有统计学意义,且HR大于1;血液灌流加使用环磷酰胺差异有统计学意义,且HR小于1,生存分析提示使用组与未使用组差异有统计学意义。多因素分析提示服毒剂量是影响患者预后的决定性指标。结论服毒剂量、AST、WBC与患者预后相关,但服毒剂量是影响预后的主要因素。尽早进行血液灌流及使用环磷酰胺联合血液灌流治疗可改善部分患者预后。

Objective To analyze the prognostic factors of acute paraquat poisoning(APP),and to explore the methods to improve the survival rate of these APP patients.Methods The clinical data of 235 APP patients from June 2013 to July 2018 were collected and analyzed retrospectively.The patients were divided into survival group and death group,and the differences of clinical characteristics and laboratory test indexes between the two groups were compared,and single-factor and multi-factor analysis and survival curve analysis were conducted.Results The mortality rate of 235 patients was 40.5%,and the average survival time was 22.35 days.Univariate analysis showed that the differences in poison dosage,blood glucose,AST,and WBC were statistically significant,and HR was greater than one.The combined use of cyclophosphamide and blood perfusion also showed a statistical difference,and HR was less than 1.Survival analysis suggested the difference between the use group and the non-use group was statistically significant.Multivariate analysis suggested that dosing was a decisive factor for the prognosis of the patients.Conclusion The dosage,AST,and WBC are related to patient prognosis,and the dosage is the main factor affecting the prognosis.Early hemoperfusion and cyclophosphamide combined with hemoperfusion can improve the prognosis of some patients.