急性百草枯中毒致MODS的临床特征分析

the MODS of Acute Paraquat Poisoning

目的:探讨急性百草枯中毒患者发展为多器官功能障碍综合征(MODS)的临床特征,为临床救治提供参考。方法:入选广西医科大学第一、二附属医院2013年7月至2020年11月急性百草枯中毒患者96例,根据病程是否合并MODS分为MODS组(n=32人)和非MODS组(n=64人)。对两组患者的一般情况、实验室指标和预后情况进行比较分析。结果:与非MODS组相比,MODS组患者服毒量更大(P<0.05),服毒至就诊时间、洗胃时间更长(P<0.05);白细胞、谷氨酸氨基转移酶、天门冬氨酸氨基转移酶、肌酸激酶、肌酸激酶同工酶、血清淀粉酶、肌酐、尿素、胱抑素C值升高更显著(P<0.05);两组患者的血红蛋白、凝血酶原时间、尿潜血、开始血液灌流时间无统计学差异(P>0.05)。结论:服毒量、服毒至就诊时间和洗胃时间、WBC升高及合并有脏器功能损害可能是急性百草枯中毒致MODS的预测因子。

Objectives:To investigate the clinical characteristics of the development of multiple organ dysfunction syndrome(MODS)in patients with acute paraquat poisoning. Methods:Patients with acute paraquat poisoning from July2013 to November 2020 in the first and second Affiliated Hospital of Guangxi Medical University were enrolled in succession,and were divided into MODS group(n=32)and non-MODS group(n=64)according to whether there were MODS,comparing and analyzing the general situation,laboratory indicators and prognosis of the two groups. Results:Compared with the non-MODS group,patients in the MODS group took more poison(P<0.05),took longer time to visit the doctor,and took longer time for gastric lavage(P<0.05). The values of white blood cell,glutamate aminotransferase,aspartate aminotransferase,creatine kinase,creatine kinase isoenzymes,serum amylase,creatinine,urea,and Cystatin C were significantly increased(P<0.05). There were no statistically significant differences in hemoglobin,prothrombin time,urine occult blood,and time to start hemoperfusion between the two groups(P>0.05). Conclusion:The amount of poison taken,the time to visit the doctor after taking the poison,the time to lavage the stomach and the increase of WBC and associated organ function impairment may be the predictors of the development of MODS in acute paraquat poisoning.