急性百草枯中毒预后影响因素分析

Analysis of prognostic factors of acute paraquat poisoning

目的 通过107例急性百草枯中毒(acute paraquat poisoning, APP)患者的临床资料分析,探讨影响APP预后的相关因素,为APP救治提供参考。方法 以2018年2月—2021年10月本院收治的107例APP患者作为研究对象,根据其转归情况分为死亡组(59例)以及存活组(48例),比较两组实验室检测指标的差异,采用多因素二元Logistic回归分析探讨APP死亡的独立危险因素,以ROC曲线评估各相关危险因素对APP预后的预测价值。结果 两组患者在年龄、住院时间、入院时呼吸频率、中毒至就诊的时间、服毒量、血百草枯(paraquat, PQ)浓度、尿PQ浓度以及实验室检测指标(WBC、中性粒细胞、血淀粉酶、白蛋白、肌酸激酶、血糖、血钾、血钠、血钙、血磷、动脉血pH、二氧化碳分压、碱剩余、乳酸)的差异有统计学意义;血淀粉酶、血钾、乳酸水平以及血PQ浓度是评估APP患者预后的独立危险因素(P<0.05)。结论 血PQ浓度、血淀粉酶、乳酸水平升高,以及血钾降低,是影响APP预后的重要因素。

Objective By analyzing the clinical data of 107 patients with acute paraquat poisoning(APP),the related factors affecting the prognosis of patients with APP were discussed to reference for the treatment of paraquat poisoning in the future.Methods 107 patients with APP admitted to our hospital from February 2018 to October 2021 were taken as the research objects and were divided into death group(59 cases) and survival group(48 cases) according to their clinical outcomes at discharge.Then, the differences of laboratory test indicators between the two groups were compared, the independent risk factors of APP death were discussed by multivariate binary Logistic regression analysis, and the receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of various risk factors for APP.Results The results showed that there were statistical differences between two groups in age, length of stay, respiratory frequency at admission, time from poisoning to hospital visit, dose of paraquat(PQ),concentrations of paraquat in blood and urine, and some laboratory test indicators(white blood cells, neutrophils, blood amylase, blood albumin, blood creatine kinase, blood glucose and blood potassium, blood sodium, blood calcium, blood phosphorus, pH of arterial blood, arterial pressure of CO2,alkali residue and lactic acid of arterial blood);while the levels amylase, potassium, lactic acid, and PQ in blood were the independent risk factors for evaluating the prognosis of APP patients(P<0.05).Conclusion The results suggested that the increase of PQ concentration, amylase and lactic acid levels in blood, and the decrease of blood potassium are important factors affecting the prognosis of APP.