动脉血乳酸水平预测急性百草枯中毒患者预后的价值  

Value of arterial lactate in predicting the prognosis of patients with acute paraquat poisoning

作　　者：严专[1] 燕宪亮[2] 赵宁军[2] 许铁[2] 

机构地区：[1]徐州医学院研究生学院,江苏省221002 [2]徐州医学院急救与救援系,江苏省221002

出　　处：《江苏医药》2015年第13期1520-1522,共3页Jiangsu Medical Journal

基　　金：徐州市科技课题(XM13B059);徐州医学院附属医院优秀中青年骨干科研基金(2011110046)

摘　　要：目的探讨动脉血乳酸预测急性百草枯中毒患者预后的价值。方法根据出院30d后的随访结果,急性百草枯中毒患者35例分为存活组(12例)和死亡组(23例),回顾性分析两组患者的住院资料,绘制入院时和入院24h的受试者工作特征曲线,分析动脉血乳酸值预测预后的灵敏度和特异度。结果入院时存活组服毒-洗胃时间短于死亡组[(4.2±0.3)h vs.(4.9±0.5)h],且动脉血乳酸值低于死亡组[(1.6±0.9)mmol/L vs.(3.8±1.1)mmol/L](P<0.05)。入院时动脉血乳酸曲线下面积(AUC)为0.93,临界值为2.63mmol/L时,高乳酸患者死亡例数多于低乳酸患者(P<0.05),灵敏度为86.9%、特异度为91.7%。入院24h后,动脉血乳酸AUC为0.78,临界值为2.24mmol/L时,高乳酸患者死亡例数多于低乳酸患者(P<0.05),灵敏度为77.9%、特异度为52.2%。结论早期动脉血乳酸值判断急性百草枯中毒患者预后有较好的预测价值。Objective To explore the value of arterial lactate in predicting the prognosis of patients with acute paraquat poisoning（APP）.Methods According to the results of follow-up on the30 th day after discharge from hospital,35 patients with APP were assigned into groups of A（survival,12cases）and B（death,23cases）.Clinical data of two groups were retrospectively analyzed.The sensitivity and specificity of arterial lactate in predicting the prognosis of APP patients were analyzed by drawing the curve of receiver-operating characteristics（ROC）.Results On admission,the time from poisoning to gastric lavage was shorter in group A than that in group B[（4.2±0.3）hours vs.（4.9±0.5）hours]（P〈0.05）.On admission,arterial lactate was lower in group A than that in group B[（1.6±0.9）mmol/L vs.（3.8±1.1）mmol/L]（P〈0.05）.The area under ROC curve（AUC）of arterial lactate was 0.93 on admission and taking 2.63mmol/L as the cutoff value,the sensitivity and specificity of arterial lactate in predicting the prognosis of APP patients were 86.9%and 91.7%,respectively,the death cases were more in the patients with arterial hyperlactacidemia than those with lower lactate（P〈0.05）.At 24 hours after admission,the AUC of arterial lactate was 0.78 on admission and taking 2.24mmol/L as the cutoff value,the sensitivity and specificity of arterial lactate in predicting the prognosis of APP patients were 77.9% and 52.2%,respectively,the death cases were more in the patients with arterial hyperlactacidemia than those with lower lactate（P〈0.05）.Conclusion In the early stage of APP,arterial lactate level has better value in predicting the prognosis of APP patients.

关 键 词：百草枯中毒 乳酸 

分 类 号：R595[医药卫生—内科学]