百草枯中毒24h后血肌酐值的预后价值分析  

Prognostic Values of Serum Creatinine in Patients with Acute Paraquat Intoxication in 24 Hours

作　　者：陈雪峰[1] 李小民[1] 刘克喜[1] 王言理[1] 陈晓兵[1] 

机构地区：[1]江苏省连云港市第一人民医院急诊科,222002

出　　处：《中国全科医学》2011年第30期3511-3512,共2页Chinese General Practice

摘　　要：目的探讨血清肌酐值对百草枯中毒患者的预后判断价值。方法入选2009年7月—2011年5月45例百草枯中毒患者,检测其入院时和入院后24 h的全血白细胞计数、血清总胆红素、血清肌酐值。30 d后统计45例中毒患者死亡和存活例数。分别计算白细胞计数、血清总胆红素、血清肌酐值异常作为判断中毒患者预后指标的敏感性和特异性。结果 45例百草枯中毒患者30 d后随访,死亡28例,生存17例,存活率为37.8%。死亡组入院后24 h白细胞计数、血清总胆红素、血清肌酐值较存活组均明显升高,差异有统计学意义(P<0.05)。入院时白细胞计数、血清总胆红素、血清肌酐值的检查结果作为对中毒的预后判断指标其敏感性均较低,分别为35.7%、32.1%和7.1%,入院后24 h的白细胞计数结果的敏感性也较低(67.8%),入院后24 h的总胆红素结果的敏感性虽高(96.4%),但特异性较低(70.5%),入院后24 h血肌酐值和百草枯中毒的预后有较好的依从性,其敏感性为100.0%,特异性为88.2%,阳性预测值为93.3%,阴性预测值为100.0%。结论入院后24 h的血清肌酐值是判断百草枯中毒预后的较好指标。Objective To explore the prognostic values of serum creatinine in patients with acute paraquat intoxication in 24 hours.Methods Forty-five patients with acute paraquat intoxication from July 2009 to May 2011 were included.Leukocyte count,total bilirubin,and serum creatinine were measured both at admission and 24 hours later.Mortality and survival cases were counted 30 days later,when sensitivity and specificity of leukocyte count,total bilirubin,and serum creatinine were calculated.Results Of the 45 cases,28 died and 17 survived 30 days later,with a survival rate of 37.8%.Leukocyte count,total bilirubin,and serum creatinine were significantly different between the death group and the survival group 24 hours after admission（P0.05）.Sensitivity of leukocyte count,total bilirubin,and serum creatinine on admission were 35.7%,32.1% and 7.1% respectively.After 24 hours,sensitivity of leukocyte count was still low（67.8%）;total bilirubin displayed a sensitivity of 96.4% while the specificity was low（70.5%）;sensitivity and specificity of serum creatinine were 100.0% and 88.2% respectively.Positive predicted value and negative predicted value of serum creatinine were 93.3% and 100.0% respectively.Conclusion Serum creatinine concentration 24 hours after admission is a relatively satisfiable index for the prognosis of paraquat intoxication.

关 键 词：百草枯 中毒 预后 

分 类 号：R595.5[医药卫生—内科学]