qSOFA评分在评估急性有机磷农药中毒严重程度中的临床价值

目的探讨快速序贯器官功能褒竭评分(qSOFA)在评估急性有机磷农药中毒(AOPP)严重程度中的临床价值。方法选取2017年1月至2019年6月收治在急诊科诊断为AOPP的94例患者为观察对象,收集每例患者的临床资料,按照qSOFA评分的结果分为4组,对比4组间各指标情况。应用ROC曲线分析qSOFA评分在评估AOPP患者严重程度中的价值。结果随着qSOFA评分的增加,住院时长、谷草转氨酶、血淀粉酶、QTc间期、乳酸、血肌酐、血糖及白细胞均升高,而胆碱酯酶、平均动脉压、pH、氧分压及碳酸氢根均下降,差异具有统计学意义(P<0.05)。1组患者中,无呼吸衰竭、应用血管活性药物、昏迷患者,无死亡病例;2组患者呼吸衰竭、应用血管活性药物、昏迷、死亡病例数分别为2例(9.5%)、1例(4.8%)、0例(0.0%)、1例(4.8%);3组分别为8例(34.8%)、10例(43.5%)、2例(8.7%)、3例(13.0%);4组分别为27例(81.8%)、27例(81.8%)、17例(51.5%)、16例(48.5%)。应用ROC曲线分析qSOFA评分在预测AOPP患者病死率中的价值,其曲线下面积为0.822(95%CI:0.731~0.912)。结论qSOFA评分在早期评估AOPP严重程度中是一个较好的指标,值得在临床上应用推广。

Objective To explore the clinical value of the Quick Sequential Organ Failure Assessment(qSOFA)in assessing the severity of acute organophosphorus pesticide poisoning(AOPP).Methods From January 2017 to June 2019,94 patients with AOPP diagnosed in the emergency department of our hospital were selected as subjects.The clinical data of each patient were collected and divided into 4 groups according to the results of qSOFA score.The indicators between the four groups were compared.The ROC curve was used to analyze the value of qSOFA score in assing the severity of patients with AOPP.Results With the increase of qSOFA score,hospitalization time,AST,blood amylase,QTc interval,lactate,serum creatinine,blood glucose and white blood cells increased,while cholinesterase,mean arterial pressure,pH,oxygen partial pressure and hydrogencarbonate decreased,and the difference was statistically significant(P<0.05).In the first group,there were no respiratory failure,no vasoactive drugs,no coma patients,and no death cases.The number of respiratory failure,vasoactive drugs,coma and death in the 2 groups were 2(9.5%),1(4.8%),0(0.0%)andI(4.8%),respectively.There were 8 cases(34.8%),10 cases(43.5%),2cases(8.7%)and3 cases(13.0%)in the 3 groups.There were 27 cases(81.8%),27 cases(81.8%),17 cases(51.5%)and 16 cases(48.5%)in 4 groups,respectively.ROC curve was used to analyze the value of qSOFA score in predicting the mortality of patients with AOPP,the area under the curve was 0.822(95%CI:0.731~0.912).Conclusion The qSOFA score isa good indicator for early asessment of the severty of patents with AOPP and is worthy of clinical application.