和肽素、APACHE Ⅱ评分在评估急性百草枯中毒患者预后的价值  

Value of Copeptin and APACHE Ⅱ Score in Evaluating the Prognosis of Patients with Acute Pa-raquat Poisoning

作　　者：何佳起 李敬[1] 李颖[2] 王荣霞[2] 孔繁托 王维展[1] 

机构地区：[1]河北医科大学附属哈励逊国际和平医院EICU,河北衡水053000 [2]河北省衡水市第二人民医院,河北衡水053000

出　　处：《医学临床研究》2014年第8期1492-1494,共3页Journal of Clinical Research

基　　金：河北省衡水市2012科研基金（12019A）资助课题项目

摘　　要：【目的】探讨和肽素、急性生理学及慢性健康状况评估Ⅱ（APACHEⅡ）在评估急性百草枯中毒（acute pa-raquat poisoning ，APP）预后的临床价值。【方法】选择126例APP患者，以住院期间临床死亡作为观察终点，分为存活组58例和死亡组68例。所有入选者在入院后2 h、24 h、7 d内抽取静脉血3 mL ，检测和肽素水平，同时连续记录APACHEⅡ评分的数据。【结果】死亡组服毒剂量显著大于存活组，而抢救时间、首次灌流时间和灌流次数之间无显著性差异（ P＞0．05）。入院后2 h和肽素水平，死亡组显著高于存活组（ P＜0．05）。而APACHEⅡ评分两组间无显著差异（ P＞0．05）。入院后24 h存活组和肽素降至正常，死亡组水平仍显著高于存活组（ P＜0．05），APACHEⅡ评分两组无差异（ P＞0．05）。入院后7 d死亡组和肽素水平持续不降，而APACHEⅡ评分水平明显升高，两组差异有明显统计学意义（P＜0．05）。APP患者口服农药剂量与和肽素、APACHEⅡ评分呈正相关。【结论】连续检测Copeptin及APACHEⅡ评分对APP患者预后的评估及合理分配医疗资源有重要临床意义。[Objective]To explore clinical value of Copeptin ,acute physiology and chronic health evaluation II （APACHE II） in the evaluation of the prognosis of acute paraquat poisoning （APP） .[Methods]Totally 126 patients with APP were selected .When clinical death during hospital stay was taken as the endpoint ,all patients were divided into survival group（ n =58） and death group（ n=68） .Venous blood 3ml of all patients was drawn at 2h ,24h and 7d after admission .The level of Copeptin was detected .APACHE Ⅱ score was also continuously recorded .[Results] The poisoning dose in death group was significantly greater than that in survival group ,while there was no significant difference in rescue time ,first time of hemoperfusion and perfusion frequency （ P〉0 .05） . The level of Copeptin in death group at 2h after admission was significantly higher than that in survival group （ P〈0 .05） ,while there was no significant difference in APACHE Ⅱ score between two groups （ P 〉0 .05） .The level of Copeptin in survival group at 24h after admission was decreased to the normal ,but that in death group was still significantly higher than that in survival group （ P 〈 0 .05） ,and there was no significant difference in APACHE Ⅱ score between two groups（ P〉0 .05） .The level of Copeptin in death group at 7d after admission was continuously decreased ,but APACHE Ⅱ score was increased obviously ,and there was significant difference between two groups（ P 〈0 .05） .Oral dose of pesticides in patients with APP was positively correlated with Copeptin and APACHE Ⅱ score .[Conclusion]Continuous measurement of Copeptin and APACHEⅡ score has important clinical significant in the evaluation of the prognosis of patients with APP and reasonable distribution of medical resources .

关 键 词：血管升压素类 阿普加评分 百草枯/中毒 急性病 预后 

分 类 号：R595[医药卫生—内科学]