APACHEⅡ评分和胆碱酯酶在评估急性有机磷农药中毒死亡风险中的应用价值研究  

Value of APACHE Ⅱ and cholinesterase in the evaluation of the death risk of acute organophosphorus pesticide poisoning

作　　者：刘玲[1] 李晓静[1] 

机构地区：[1]安徽省立医院急救中心,合肥230001

出　　处：《中国急救医学》2009年第1期21-23,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的应用急性生理和慢性健康状况评分Ⅱ（APACHEⅡ）及血清胆碱酯酶（CHE）评估有机磷农药中毒患者的病情危重程度并判断其预后，证明其有效性与否。方法回顾性分析我院急性有机磷农药中毒病例53例，分别计算APACHEⅡ评分，并进行验证，建立回归模型，同时将其入院24h内血清胆碱酯酶最低值进行比较。结果53例患者中，存活38例，死亡15例。存活组APACHEⅡ评分（16．77±6．97）分，死亡组APACHEⅡ评分（33．00±4．09）分，两组比较差异有统计学意义（P〈0．01）；存活组胆碱酯酶（513．7±401．92）IU／L，死亡组胆碱酯酶（501．60±416．09）IU／L，两组比较差异无统计学意义（P=0．925）。进行Logistic回归分析后得到死亡风险模型。结论APACHEⅡ评分系统能客观准确地反映有机磷农药中毒患者的病情危重程度及预后，可应用于有机磷农药中毒患者的病情危重程度及死亡风险的评估，具有很高的临床应用价值。胆碱酯酶只能作为中毒诊断的参考指标，不能作为病情危重度的判断指标。Objectives To assess the severity and prognosis of acute organophosphorus pesticide （ AOPP ） poisoning patients by using the Acute Physiology and Chronic Health Evaluation （ APACHE ） Ⅱ and cholinesterase （ CHE ）. Methods 53 AOPP patients were analyzed with APACHE Ⅱ retrospectively, and regression model was made. At the same time, the lowest CHE values of the hospitalized patients within the first 24 hours were compared. Results 38 survived and 15 died in the 53 cases. In the survival group, the average APACHEⅡscore was 16.77 ±6. 97, the average CHE value was [ 513.7 ±401.92 ） IU/ L. In the death group, the average score was 33.00 ± 4.09, the average CHE value was （ 501.60 ± 416.09 } IU/L. The two groups had significant differences in APACHEⅡ score （ P 〈 0.01 ） , but not in CHE （ P = 0. 925 }. Pattern of death risk was got from Logistic regression analysis. Condusion APACHEⅡcan reflect the severity and prognosis of AOPP patients objectively and exactly, and it can be used to evaluate the severity and death risk of those patients, it is of great value in clinical application. The value of CHE can only be used to diagnose, but not to evaluate the severity of AOPP patients.

关 键 词：急性生理和慢性健康状况评分Ⅱ 胆碱酯酶 急性有机磷农药中毒 死亡风险 

分 类 号：R595.4[医药卫生—内科学]