急性百草枯中毒患者多器官功能损害的动态变化及临床意义  

Dynamic changes and clinical significance of multiple organ damage in patients with acute paraquat poisoning

作　　者：蒋黎[1] 方建江[1] 何旭娟[1] 夏菁[1] 刘雪兰[1] 

机构地区：[1]宁波市医疗中心李惠利医院急诊科,浙江宁波315040

出　　处：《中国现代医生》2014年第34期81-84,共4页China Modern Doctor

基　　金：浙江省宁波市医学科技计划项目(2013A03)

摘　　要：目的分析百草枯中毒患者心、肺、肝、肾、胰腺功能损害的变化,探讨其对预后的影响。方法将我院救治的急性百草枯中毒患者77例根据入院30 d时的结局,分成存活组和死亡组;检测中毒患者不同时间心、肺、肝、肾、胰腺功能的多项指标,比较两组患者指标的差异。结果中毒时间及预后是器官功能损害的影响因素。CKMB、LDH、Cr、Amy入院第3天达到峰值;ALT、TBIL、Lactic Acid 1周达到峰值;Pa CO2第3天达到谷值。两组患者的Lactic Acid差异在1周内差异无统计学意义(P>0.05),1周后有统计学意义(P<0.05);其他指标在各个时间节点的比较差异有统计学意义(P<0.05)。结论急性百草枯中毒患者早期出现多器官功能损害,重要器官的严重损害可能是预后不良的指标。〈〈Objective To analyze the changes of cardiac,lung,liver,kidney function and amylase levels in the patients of acute paraquat poisoning and their implication on prognosis. Methods According to the final results, the patients were divided into two groups, survival group and death group. Several parameters,including creatine kinase-MB（CK-MB）,lactate dehydrogenase（LDH）, aminotransferase（ALT）, Total bilirubin（TBil）, creatinine（Cr）, serum amylase（S-Amy）,lactic acid and Pa CO2 were measured in different time points, and above parameters in two groups were compared. Results Prognosis and time point after poisoning were two influence factors of organ function damage. In both groups, the level of CK-MB, LDH, Cr, Amy reached peak point on third day after adimission, and the level of ALT, TBIL, Lactic Acid reached peak point on seventh day, but the level of Pa CO2 reached valley point on third day. There was significant difference on the level of Lactic Acid between survival group and death group after seven-days＇ admission（P〈0.05）,but no significant difference with seven-days＇ admission（P〉0.05）. While there was significant difference on the level of other parameters on different time points between two groups（P〈0.05）. Conclusion Early stage of paraquat poisoning demonstrated cardiac occurs multiorgan dysfunction, and the severe damages of organs implicates a poor prognosis.

关 键 词：百草枯 中毒 器官功能 预后 

分 类 号：R595.4[医药卫生—内科学]