百草枯中毒患者外周血对氧磷酯酶1、程序性死亡因子-1、γ干扰素诱导蛋白-10水平检测的意义

Significance of detecting paraoxonase 1,programmed death factor-1 and interferon-gamma inducible protein-10 levels in peripheral blood of patients with paraquat poisoning

目的探讨百草枯中毒患者外周血对氧磷酯酶1(PON1)、程序性死亡因子-1(PD-1)、γ干扰素诱导蛋白-10(IP-10)水平对预后的价值。方法对2017年5月—2023年4月中国人民解放军联勤保障部队第九八〇医院120例百草枯中毒患者进行前瞻性研究,统计百草枯中毒患者30 d内死亡与生存情况,比较不同预后患者临床资料及外周血PON1、PD-1、IP-10水平。采用Pearson相关性分析探讨外周血PON1、PD-1、IP-10水平与中毒剂量、序贯器官衰竭估计(SOFA)评分、急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分的相关性;采用受试者工作特征(ROC)曲线评价外周血PON1、PD-1、IP-10水平预测百草枯中毒患者预后的价值。结果随访期间共35例患者死亡(29.17%)。死亡患者中毒剂量、SOFA评分、APACHEⅡ评分及外周血IP-10、PD-1水平均高于生存患者,外周血PON1水平低于生存患者,差异有统计学意义(P<0.05)。相关性分析显示,百草枯中毒患者外周血PON1水平与中毒剂量、APACHEⅡ评分及SOFA评分均呈负相关,PD-1、IP-10水平与中毒剂量、APACHEⅡ评分及SOFA评分均呈正相关(P<0.05);PON1、PD-1、IP-10预测百草枯中毒的曲线下面积(AUC)分别为0.738、0.774、0.770,三者联合预测的AUC为0.922,三者联合预测效能高于各指标单独预测。结论百草枯中毒患者外周血PON1、PD-1、IP-10联合检测对判断患者预后具有较高价值。

Objective To explore the value of detecting the levels of paraoxonase 1(PON1),programmed death factor-1(PD-1),and interferon gamma-induced protein-10(IP-10)in peripheral blood of patients with paraquat poisoning.Methods A prospective study was conducted in 120 patients with paraquat poisoning in the 980th Hospital of the Joint Logistics Support Force of Chinese people′s Liberation Army from May 2017 to April 2023.The mortality and survival status of patients with paraquat poisoning within 30 days were statistically analyzed.The clinical data and peripheral blood PON1,PD-1,and IP-10 levels of patients with different prognoses were compared.Pearson correlation analysis was used to analyze the correlations of the peripheral blood PON1,PD-1,and IP-10 levels with the toxic dose,Sequential Organ Failure Assessment(SOFA),and Acute Physiology and Chronic Health Evaluation SystemⅡ(APACHEⅡ).The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the peripheral blood PON1,PD-1,and IP-10 levels for the prognosis of patients with paraquat poisoning.Results During the follow-up period,a total of 35 patients died(29.17%),with the toxic dose,SOFA score,APACHEⅡscore,IP-10 level,PD-1 level of the dead patients were higher than those of the surviving patients,and the peripheral blood PON1 level was lower than that of the control group(P<0.05).The correlation analysis showed that the level of PON1 in peripheral blood of paraquat poisoning patients was negatively correlated with the dose of poisoning,APACHEⅡ,and SOFA scores,while the levels of PD-1 and IP-10 were positively correlated with the dose of poisoning,APACHEⅡ,and SOFA scores(P<0.05).The area under the curve(AUC)values for predicting paraquat poisoning using PON1,PD-1,and IP-10 were 0.738,0.774,and 0.770,respectively.The combined prediction AUC value of the three was 0.922,which was significantly higher than that of each individual indicator.Conclusion Combined peripheral blood PON1,PD-1,and IP-10 testing in patients with paraquat poisoning is of high value in determining prognosis of patients.