百草枯中毒患者心电图变化与预后的分析

The relevance of electrocardiographic abnormalities and prognosis in patients with paraquat poisoning

目的分析心电图节律与波形变化和百草枯(PQ)中毒患者预后之间的关系,为PQ中毒患者病情评估提供方法。方法于2022年1月,回顾性分析2016年1月1日至2021年12月31日收住温州医科大学附属第一医院的PQ中毒患者,采集患者一般资料和入院24 h内心电图相关指标。应用单因素及多因素logistic回归分析PQ中毒患者死亡相关危险因素,用受试者工作特征(ROC)曲线评估各个指标对PQ中毒患者预后判断价值。结果共纳入PQ中毒患者145例,存活84例,死亡60例。单因素logistic回归分析发现,心电图的心率(P=0.000)、QTc(P=0.000)、ST-T改变(P=0.007)与患者预后相关。多因素logistic结果显示心率(OR=1.059,95%CI 1.033~1.086)及QTc(OR=1.015,95%CI:1.000~1.029)是临床PQ中毒患者死亡的独立危险因素(P<0.05)。ROC曲线分析发现,心率与QTc构建的预测模型曲线下面积(AUC)为0.832(95%CI:0.765~0.899)。结论心率、QTc及两者联合构建预测模型均可为PQ中毒患者预后判断提供参考。

Objective To investigate the relationship between electrocardiographic(ECG)changes and prognosis of paraquat poisoning patients,so as to provide evidence for the condition assessment in paraquat poisoning patients.Methods In January 2022,The clinical data of paraquat poisoning patients were retrospectively analyzed in the First Affiliated Hospital of Wenzhou Medical University from January 1,2016 to December 31,2021.The patients'basic information(age,sex,underlying disease,and occupation)and the ECG within 24 hours were collected,and the data were statistically analyzed by SPSS 22.0.One variable analysis and multivariable logistic regression analysis were used to analyze the risk factors related to prognosis determine in their ECG.The receiver operating characteristic(ROC)curve were used to evaluate the diagnostic value of ECG indexes in patients with paraquat poisoning.Results A total of 145 patients with paraquat poisoning were finally enrolled in this study,there were 84 patients survived and 60 patients died.One variable analysis revealed that heart rate(P=0.000),QTc changes(P=0.000),and ST-T changes(P=0.007)of ECG had statistically significant differences in the prognosis of paraquat poisoning patients between the survival group and the death group.Multifactorial logistic results showed that heart rate(OR=1.059,95%CI:1.033~1.086)and QTc(OR=1.015,95%CI:1.000~1.029)were independent risk factors for death diagnosis of patients with paraquat poisoning(P<0.05).ROC curve analysis revealed that the area under the cure(AUC)of the prediction model constructed based on heart rate and QTc was 0.832(95%CI:0.765~0.899),with the best diagnostic efficacy.Conclusion Heart rate,QTc and the prediction model constructed based on both can be used as prognostic indicators for the diagnosis of patients with paraquat poisoning,and which have reference value for clinical prognosis diagnosis.