尿百草枯与动脉血乳酸浓度对急性百草枯中毒的预后评估  

Effect of urine paraquat concentration and arterial blood lactate concentration on prognosis of acute paraquat poisoning

作　　者：宁芳[1] 吴蒙[1] 赵彪[1] 张云东[1] 夏万昱 刘志三 

机构地区：[1]安徽省亳州市人民医院北院急诊内科,236800

出　　处：《淮海医药》2015年第5期442-444,共3页Journal of Huaihai Medicine

摘　　要：目的观察急性百草枯中毒(APP)患者入院时尿百草枯(PQ)浓度与动脉血乳酸(Lac)浓度变化,探讨APP患者预后特异度和敏感度较高的监测指标。方法收集我院急诊内科2012年1月-2015年1月APP患者142例的临床资料,根据中毒后30 d是否死亡分为死亡组与存活组,记录入院时尿PQ浓度和血Lac浓度,通过ROC曲线评估其对APP预后的诊断价值。结果死亡组患者入院时尿PQ浓度和血Lac浓度明显高于存活组(P<0.05);两者对APP患者死亡预测的ROC曲线下面积(AUC)显示,尿PQ浓度的AUC为0.843,截断值为50.12 mg/L,敏感度为78.6%,特异度为88.5%,Youden指数0.671;血Lac浓度的AUC为0.782,截断值为3.76 mmol/L,敏感度为85.4%,特异度为76.7%,Youden指数0.621。结论入院时尿PQ浓度(≥50.12 mg/L)和(或)血Lac浓度(≥3.76 mmol/L)可作为预测APP患者预后的参考指标。Objective To summarize the urine paraquat（PQ） concentration and arterial lactate（Lac） concentration of patients with acute paraquat poisoning（APP） and investigate the gold-standard of APP prognosis.Methods A total of 142 patients with APP were analyzed.According to the situation of the patients after 30 days of poisoning,2 groups were divided.Concentrations of urine PQ and Lac were recorded to evaluate the diagnostic effect through ROC curves.Results Concentration in the death group was significantly higher than that in the survival group（P 〈0.05）.Set against the urine PQ concentration, AUC was 0.843,cutoff value was 50.12mg/L,sensitivity was 78.6%,specificity was 88.5%,and Youden index was 0.671. As for the Lac concentration,AUC was 0.782,cutoff value was 3.76mmol/L,sensitivity was 85.4%,specificity was 76.7%, and Youden index was 0.621.Conclusion The urine PQ concentration and/or arterial Lac concentration might be indicators to the prognosis of APP patients.

关 键 词：百草枯 中毒 尿液 乳酸 预后 

分 类 号：R595.4[医药卫生—内科学]