二氧化碳结合力变化对急性百草枯中毒预后判断的价值分析  

Investigation of the prognostic values of variation of carbon dioxide combining power(CO_2-CP)in patients with acute paraquat intoxication

作　　者：兰超[1] 李璐[1] 李莉[1] 王金柱[2] 孙昌华[1] 

机构地区：[1]郑州大学第一附属医院急诊科,450052 [2]郑州大学附属郑州市中心医院急诊科,450052

出　　处：《实用医学杂志》2015年第3期388-391,共4页The Journal of Practical Medicine

基　　金：河南省重点科技攻关计划项目(编号:102102310094);河南省医学科技攻关计划项目(编号:201003049);国家临床重点专科(编号:2012649)

摘　　要：目的：探讨静脉血二氧化碳结合力（CO2-CP）与急性百草枯中毒预后的关系。方法：回顾性分析2011年1月至2013年12月我院收治的220例急性百草枯中毒患者的临床资料，记录中毒剂量、中毒距就诊时间、中毒距洗胃时间、中毒后24h内白细胞计数（WBC）、中毒后并发症、血肌酐（SCr）、尿素氮（BUN）、静脉血CO2-CP、有无氧饱和度（SaO2）〈0．90的时间及急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ评分）等指标。结果：CO2-CP的受试者工作特征曲线（ROC曲线）下面积（AUC）为0．746（95％CI：0．673～0．819，P〈0．05），以CO2-CP≥15．5mmol／L为判断预后的临界值，其判断存活的敏感度和特异度分剐为91．7％和70．0％；多因素Logistic回归分析结果显示CO2-CP可作为判断百草枯中毒预后的独立危险因素（OR=4．583，95％CI：2．226—9．437，P〈0．05）。结论：检测静脉血C02-CP简单可行，可作为判断急性百草枯中毒预后的敏感指标，中毒早期出现CO2-CP下降提示预后差。Objective To investigate the prognostic values of variation of carbon dioxide combining power （C02-CP） in venous blood in patients with acute paraquat intoxication. Methods The clinical data of 220 pa- tients with acute paraquat intoxication admited to my hospital were collected during the period from January 2011 to December 2013. The following data were checked in poisoning doses,time elapsed from poisoning to admis- sion, time elapsed from poisoning to gastric lavage,white blood cell （WBC）, complication, serum creatinine （SCr）, blood urea nitrogen（BUN）, venous blood CO2-CP, presence of SaO2 〈 90% and APACHE Ⅱ scores at admission and 24 hours later. Results The area under ROC curve of CO2-CP was 0.746 [95% CI （0.673 - 0.819）,P 〈 0.05]. Sensitivity and specificity to predict survival were 91.7% and 70.0% respectively when CO2- CP ≥ 15.5 mmol/L. Multivariate logistic regression revealed that the odds ratio （OR） of CO2-CP 〈 15.5 mmol/ L was 4.583 （95% CI was 2.226 - 9.437, P 〈 0.05）. Conclusion Detection of venous blood CO2-CP is simple and feasible and the CO2-CP is a relatively sensitive index and an independent factor for the prognosis of paraquat intoxication. The decrease of CO2-CP in the early period of poisoning indicates worse prognosis.

关 键 词：百草枯 二氧化碳结合力 预后 

分 类 号：R595.4[医药卫生—内科学]