尿中百草枯半定量试验对急性百草枯中毒的预后评估  

Prognosis value of urine paraquat semi-quantitative in the patients with acute paraquat poisoning

作　　者：刘尊齐[1] 刘东兴[1] 张兴国[1] 王海石[1] 郝凤桐[2] 

机构地区：[1]山东大学附属省立医院急救中心,济南250021 [2]北京朝阳医院

出　　处：《中华劳动卫生职业病杂志》2014年第5期378-380,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的 研究尿中百草枯（paraquat,PQ）半定量试验对急性PQ中毒严重程度评估的意义.方法 依据尿中PQ半定量试验结果将179例PQ中毒病例分为＋组（36例）、＋＋组（23例）、＋＋＋组（25例）和＋＋＋＋组（95例）,比较4组病例的临床特征、肝肾损害程度、呼吸衰竭和临床分型,用Kaplan-Meier法进行生存率分析.结果 179例PQ中毒患者死亡81例,病死率为45.25％.＋组病例无严重并发症,＋＋＋＋组病例急性呼吸、肝肾衰竭发生率明显高于＋组、＋＋组和＋＋＋组,差异均有统计学意义（P＜0.05）.尿中PQ浓度与急性PQ中毒临床严重程度分级呈正相关,相关系数为0.720（P＜0.01）.Kaplan-Meier生存分析显示,＋＋＋＋组病死率（73.7％）明显高于＋＋＋组（40.0％）、＋＋组（4.3％）和＋组（0％）,差异有统计学意义（P＜0.05）.结论 尿PQ半定量试验可较好判断急性PQ中毒的严重程度,可对急性PQ中毒患者指导治疗,预测预后.Objective To investigate the relationship between semi-quantification of urine paraquat and the severity of acute paraquat poisoning,and to evaluate the prognostic value of the test in patients with acute paraquat poisoning.Methods A total of 179 patients with acute paraquat poisoning were categorized into four groups according to their semi-quantification results of urine paraquat：＋group （n=36）,＋＋group （n=23）,＋＋＋ group （n=25）,and ＋＋＋＋group （n=95）.The clinical features,severity of hepatic and renal injuries,respiratory failure,and clinical classification were compared between these four groups.Kaplan-Meier analysis was used to evaluate the survival rate.Results The 60-day mortality was 45.25％ （81/179）.The amount of ingestion increased significantly from ＋group to ＋＋＋＋group （P＜0.05）.No patient in ＋group was found to have serious complications,while most patients in ＋＋＋＋group suffered organ dysfunction or even organ failure.The incidence of acute respiratory failure,renal failure,and hepatic failure in ＋＋＋＋group was significantly higher than that in ＋group,＋＋group,and ＋＋＋group （P＜0.05）.The urine paraquat concentration was positively correlated with the clinical severity of acute paraquat poisoning （Spearman correlation coetficient=0.720,P＜0.01）.Kaplan-Meier survival analysis showed that the mortality of ＋＋＋＋group （73.7％） was significantly higher than that of ＋＋＋ group （40％）,＋＋group （4.3％）,and ＋group （0％） （P＜0.05）.Conclusion The semi-quantification of urine paraquat is a promising test in evaluating the severity of acute paraquat poisoning.This test can be used to guide therapy and to predict the outcomes of patients suffering acute paraquat poisoning.

关 键 词：百草枯 中毒 预后评价 

分 类 号：R139.3[医药卫生—劳动卫生]