|本期目录/Table of Contents|

[1]李亮,陈鑫,任艺,等.急性百草枯中毒患者血清磷水平与患者死亡预后的相关性[J].医学研究与战创伤救治(原医学研究生学报),2017,19(06):561-564.[doi:10.3969/j.issn.1672-271X.2017.06.001]
 LI Liang,CHEN Xin,REN Yi,et al.Correlation analysis between serum phosphorus levels and 28-day mortality in patients with acute paraquat poisioning[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(06):561-564.[doi:10.3969/j.issn.1672-271X.2017.06.001]
点击复制

急性百草枯中毒患者血清磷水平与患者死亡预后的相关性()

《医学研究与战创伤救治》(原医学研究生学报)[ISSN:1672-271X/CN:32-1713/R]

卷:
第19卷
期数:
2017年06期
页码:
561-564
栏目:
出版日期:
2017-11-23

文章信息/Info

Title:
Correlation analysis between serum phosphorus levels and 28-day mortality in patients with acute paraquat poisioning
作者:
李亮陈鑫任艺汪林孙兆瑞聂时南
作者单位:210002南京,南京军区南京总医院急救医学科
Author(s):
LI LiangCHEN XinREN YiWANG LinSUN Zhao-ruiNIE Shi-nan
(Department of Emergency, Nanjing General Hospital of Nanjing Military Region, PLA, Nanjing 210002, Jiangsu, China)
关键词:
百草枯中毒血清磷预后
Keywords:
Paraquat poisioningSerum phosphorusPrognosis
分类号:
R595.4
DOI:
10.3969/j.issn.1672-271X.2017.06.001
文献标志码:
A
摘要:
目的探讨百草枯(PQ)中毒患者血清磷水平与患者死亡预后的相关性。方法回顾性分析在南京军区南京总医院急诊重症监护室确诊为急性百草枯中毒58例患者临床资料,根据临床预后分为死亡组(n=46)和生存组(n=12),比较2组患者血清磷水平以及其他临床相关指标间的差异性,并通过ROC曲线分析、相关性分析、Logistic回归分析评估血清磷水平与患者28d死亡预后的相关性。 结果死亡组患者的血清磷水平明显低于生存组患者[(0.34±0.03)mmol/L vs (0.65±0.07)mmol/L,P<0.05];血清磷水平与28d死亡事件发生存在明显负相关(r=-0.524,P<0.05);ROC曲线分析示血清磷、APACHEII评分和百草枯口服量对死亡预后的AUC分别为0.737、0.683和0.724;Logistic回归分析血清磷[(≤0.032mmol/L)OR=1.48,95%CI 0.82~3.13,P<0.05]和百草枯口服量[(≥15.8mL)OR=2.12,95%CI 0.79~5.07,P<0.05]为百草枯中毒患者死亡发生的独立危险因素。结论百草枯中毒患者早期血清磷水平与患者28d死亡率密切相关,可作为评估患者预后的有效指标。
Abstract:
ObjectiveTo discuss and analyze the correlation between serum phosphorus levels and 28-day mortality in patients with acute paraquat poisioning.MethodsFifty-eight patients with acute PQ poisioning were enrolled in this study. Based on the results of 28-day mortality, all the patients were divided into two groups: dead group (n=46) and survival group (n=12). Compare the serum levels of phosphorus and other clinical records, and through ROC curve, correlation analysis and regression analysis were used to estimate the association between serum phosphorus levels and 28-day mortality.ResultsThe levels of serum phosphorus in death group were significantly longer than those of in survival group [(0.34±0.03) mmol/L vs (0.65±0.07) mmol/L, P<0.05]. Correlation analysis showed levels of phosphorus were negative correlation with 28-day death (r=-0.524, P<0.05). ROC analysis showed that the AUC of serum phosphorus, APACHE II score and PQ dosage were0.737, 0.683 and 0.724 respectively. Logistic regression analysis showed PQ intoxication dosage (≥15.8 mL) (OR=2.12, 95%CI 0.79-5.07, P<0.05) and serum phosphorus levels (≤0.032 mmol/L) (OR=1.48, 95%CI 0.82-3.13, P<0.05) were independently risk factors for death by PQ poisoning.ConclusionThe serum phosphorus is related with 28-day mortality in acute paraquat poisioning patients

参考文献/References:

[1]Toygar M, Aydin I, Agilli M, et al. The relation between oxidative stress, inflammation,and neopterin in the paraquat-induced lung toxicity[J]. Hum Exp Toxicol,2015, 34(2):198-204.
[2]杨志洲,聂时南.急性百草枯中毒诊治研究进展[J].医学研究生学报,2013,26(10):1101-1104.
[3]Dinisoliveira RJ, Duarte JA, Sáncheznavarro A, et al. Paraquat poisonings: mechanisms of lung toxicity, clinical features, and treatment[J]. Crit Rev Toxicol, 2008, 38(1):13-71.
[4]徐华,陈建洪.连续性静脉-静脉血液滤过联合血液灌流对百草枯中毒疗效的研究[J].东南国防医药,2017,19(2):157-159.
[5]Shimada N, Nakamura T, Takahashi Y, et al. Effect of polymyxin B-immobilized fiber on serum phosphate concentrations in patients with sepsis[J]. Nephron, 2000, 86(3):359-360.
[6]Cokun R, Gündogˇan K, Baldane S, et al. Refeeding hypophosphatemia: a potentially fatal danger in the intensive care unit[J]. Turk Med Sci, 2014, 44(3):369-374.
[7]Novaes RD, Gonalves RV, Cupertino MC, et al. Acute paraquat exposure determines dose-dependent oxidative injury of multiple organs and metabolic dysfunction in rats: impact on exercise tolerance[J]. Int J Exp Pathol, 2016, 97(2):114-124.
[8]Yamashita M, Yamashita M, Ando Y. A long-term follow-up of lung function in survivors of paraquat poisoning[J]. Hum Exp Toxicol, 2000, 19(2):99-103.
[9]Shen H, Wu N, Wang Y, et al. Chloroquine attenuates paraquat-induced lung injury in mice by altering inflammation, oxidative stress and fibrosis[J]. Int Immunopharmacol, 2017, 46:16-22.
[10]Xu J. Lycopene counters certain negative consequences of paraquat induced oxidative stress[J]. Heart, 2015, 94(7):848-854.
[11]He F, Xu P, Zhang J, et al. Efficacy and safety of pulse immunosuppressive therapy with glucocorticoid and cyclophosphamide in patients with paraquat poisoning: A meta-analysis[J]. Int Immunopharmacol, 2015, 27(1):1-7.
[12]符加红,臧彬.重症监护病房患者低磷血症的发生及对预后的影响[J].中国危重病急救医学,2012,24(1):29-32.
[13]Shi Y, Bai Y, Zou Y, et al. The value of plasma paraquat concentration in predicting therapeutic effects of haemoperfusion in patients with acute paraquat poisoning[J]. PLoS One, 2012, 7(7):e40911.doi: 10.1371/journal.pone.0040911.
[14]Silva MF, Saldiva PH. Paraquat poisoning: an experimental model of dose-dependent acute lung injury due to surfactant dysfunction[J]. Braz J Med Biol Res, 1998, 31(3):445-450.
[15]Li A, Li W, Hao F, et al. Early stage blood purification for paraquat poisoning: a multicenter retrospective study[J]. Blood Purif, 2016, 42(2):93-99.
[16]Xu S, Hu H, Jiang Z, et al. APACHE score, Severity Index of Paraquat Poisoning, and serum lactic acid concentration in the prognosis of paraquat poisoning of Chinese Patients[J]. Pediatr Emerg Care, 2015, 31(2):117-121.
[17]Huang NC, Hung YM, Lin S L, et al. Further evidence of the usefulness of acute physiology and chronic health evaluation II scoring system in acute paraquat poisoning[J]. Clin Toxicol, 2006, 44(2):99-102.
[18]Tonelli M, Curhan G, Pfeffer M, et al. Relation between alkaline phosphatase, serum phosphate, and all-cause or cardiovascular mortality[J]. Circulation, 2009, 120(18):1784.
[19]Pesta DH, Tsirigotis DN, Befroy DE, et al. Hypophosphatemia promotes lower rates of muscle ATP synthesis[J]. Faseb J, 2016, 30(10):3378-3387.
[20]李静, 尉俊生. 重症肺炎患者血清磷水平与30d病死率的相关性研究[J]. 检验医学与临床, 2016, 13(18):2607-2609.

相似文献/References:

[1]刘云豹,喻明,孙怡,等.药用炭降低慢性肾功能衰竭患者血磷水平及钙磷乘积的作用[J].医学研究与战创伤救治(原医学研究生学报),2016,18(02):194.[doi:10.3969/j.issn.1672-271X.2016.02.028]
[2]徐华,陈建洪.连续性静脉-静脉血液滤过联合血液灌流对百草枯中毒疗效的研究[J].医学研究与战创伤救治(原医学研究生学报),2017,19(02):157.[doi:10.3969/j.issn.1672-271X.2017.02.011]
 XU Hua,CHEN Jian-hong.Efficacy of continuousveno venous hemofiltration combined with hemoperfusion in treatment of paraquat poisoning[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(06):157.[doi:10.3969/j.issn.1672-271X.2017.02.011]

备注/Memo

备注/Memo:
基金项目:国家自然科学基金(81401583);全军后勤面上项目(CNJ14L002);南京军区南京总医院科研基金(2016032)
更新日期/Last Update: 2017-11-20