APACHEⅡ评分与重度有机磷中毒患者肠道屏障功能的相关性分析

Correlation between ApacheⅡ score and intestinal barrier function in patients with severe organophosphorus poisoning

目的分析急性生理与慢性健康状况系统Ⅱ(APACHEⅡ)评分与重度有机磷中毒患者肠道屏障功能的相关性。方法回顾性选取2017年1月至2019年12月安徽理工大学附属亳州市人民医院收治的119例重度有机磷中毒患者。按照患者预后情况,将患者分别纳入存活组80例、病死组39例。记录患者入院即刻及入院48、72、144 h APACHEⅡ评分,并检测其对应时点D-乳酸(D-L)、二胺氧化酶(DAO)、内毒素(LPS)、肠脂肪酸结合蛋白(I-FABP)水平。应用Pearson相关性分析,总结APACHEⅡ评分与患者肠道屏障功能的相关性。结果119例患者中,存活80例,病死39例,病死率32.77%。存活组与病死组入院后48、72、144 h血浆D-L、LPS水平均较入院即刻下降,存活组入院即刻及入院后48、72、144 h血浆D-L、LPS水平均低于病死组同期水平,差异有统计学意义(P<0.05)。存活组与病死组入院后48、72、144 h血浆DAO、I-FABP水平均较入院即刻下降,存活组入院即刻及入院后48、72、144 h血浆DAO、I-FABP水平均低于病死组同期水平,差异有统计学意义(P<0.05)。存活组与病死组入院后48、72、144 h APACHEⅡ评分均较入院即刻下降,存活组入院即刻及入院后48、72、144 h APACHEⅡ评分均低于病死组同期水平,差异有统计学意义(P<0.05)。Pearson相关性分析显示,APACHEⅡ评分与D-L、LPS、DAO、I-FABP均呈正相关(P<0.05)。结论重度有机磷中毒患者肠黏膜通透性的上升与肠黏膜损伤的加剧伴随着APACHEⅡ评分的升高,以及病死风险的增加。

Objective To analyze the correlation between acute physiology and chronic health evaluationⅡ(APACHEⅡ)and intestinal barrier function in patients with severe organophosphorus poisoning.Methods One hundred and nineteen patients with severe organophosphorus poisoning admitted to Bozhou People's Hospital,Anhui University of Science and Technology from January 2017 to December 2019 were selected.The patients were included in the survival group of 80 cases and the death group of 39 cases according to the prognosis of the patients.APACHEⅡscores were recorded immediately after admission and 48 h,72 h and 144 h after admission.D-lactate(D-L),diamine oxidase(DAO),lipopolysaccharide(LPS),intestinal fatty acid binding protein(I-FABP)were measured at corresponding time points.Pearson correlation analysis was used to summarize the correlation between APACHEⅡscore and intestinal barrier function.Results Among 119 patients,80 survived and 39 died,with a mortality rate of 32.77%.The levels of plasma D-L and LPS in the survival group and the death group at 48 h,72 h and 144 h after admission were lower than those in the death group(P<0.05).The plasma DAO and I-FABP of the survival group and the death group were lower than those of the death group at 48 h,72 h and 144 h after admission.The difference was statistically significant(P<0.05).The APACHEⅡscores of the survival group and the death group were lower than those of the death group at 48 h,72 h and 144 h after admission.The APACHEⅡscores of the survival group and the death group at 48 h,72 h and 144 h after admission were lower than those of the death group at the same time(P<0.05).Pearson correlation analysis showed that APACHEⅡscore was positively correlated with D-L,LPS,Dao and I-FABP(P<0.05).Conclusion The increase of intestinal mucosal permeability and intestinal mucosal injury in patients with severe organophosphorus poisoning is accompanied by the increase of APACHEⅡscore and the risk of death.