初始血乳酸水平与急性口服百草枯中毒患者预后的相关性分析  

Correlation analysis of initial blood lactate level with prognosis of acute oral paraquat poisoning

作　　者：吴嘉荔[1] 冀晓静 马晓[1] 杨立山[1] Wu Jia-li;Ji Xiao-ring;Ma Xiao;Yang Li-shan(Department of Emergency,General Hospital of Ningxia Medical University,Yinchuan 750004,Chin)

机构地区：[1]宁夏医科大学总医院急诊科,宁夏银川750004 [2]中国人民解放军第五医院检验科,宁夏银川750004

出　　处：《中国急救医学》2018年第8期724-727,I0004,共5页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨急性口服百草枯中毒患者初始血乳酸（Lac）水平与患者预后之间的关系。 方法 回顾性分析2010-01~2015-12 收治的急性口服百草枯中毒患者51例资料，并根据患者血Lac水平将其分为五组，记录患者入院时血Lac水平、性别、年龄、中毒至就诊时间及中毒至洗胃时间等相关临床资料，通过Cox比例风险模型进行单因素及多因素分析，同时观察研究不同水平下的血Lac与患者预后的关联，并通过Kaplan-Meier绘制生存曲线。 结果 51例患者口服百草枯剂量的中位数为30（30，50）mL；尿百草枯定性实验结果为弱阳性5（9.8%）例，阳性4（7.8%）例，强阳性42（82.4%）例。其中死亡34（66.7%）例，存活17（33.3%）例。单因素分析结果显示，口服百草枯剂量、尿百草枯定性试验及血Lac水平与患者预后（是否死亡）相关。通过调整尿检、口服百草枯剂量、就诊时间、洗胃时间后的Cox比例风险模型结果显示，血Lac在6 mmol/L≤血Lac〈8 mmol/L组（HR=11.96，95%CI2.52～56.72）及血Lac≥8 mmol/L组（HR7.83，95%CI2.08～29.37）与0≤血Lac〈2 mmol/L组比较，差异均有统计学意义（P〈0.01）。不同血Lac水平下患者的生存曲线显示，随着血Lac水平的增加，患者生存率也逐渐下降，差异有统计学意义（P〈0.01）。 结论 急性口服百草枯中毒患者初始血Lac水平与患者预后具有相关性，血Lac水平越高，患者死亡风险越高，生存时间越短。Objective To investigate the relationship between initial lactate （Lac） level and prognosis with acute oral paraquat poisoning patients. Methods This is a retrospective analysis study, including 51 acute oral paraquat poisoning patients information from January 2010 to December 2015 who were admitted to hospital and were divided into five groups according to Lac level. Lac level, gender, age, poisoning to treatment time, poisoning to gastric lavage time and other related information were collected to analyze the relationship of patients＇ initial Lac level. Cox proportional hazards model was used for univariate and multivariate analysis, the relationship between different Lac levels and the prognosis of patients was analyzed, and the survival curve was drawn through Kaplan - Meier. Results The median dose of 51 oral paraquat patients were 30 （30, 50） mL, the paraquat qualitative test results showed that weak positive case were 5 （9.8%） , positive case were 4 （7.8%）, strongly positive case were 42（82.4% ）. Among all patients, death cases were 34 （66.7%） and the survival cases were 17 （33.3%）. Univariate analysis showed that oral paraquat dose, paraquat urine qualitative tests and Lac levels correlated with patient outcome. After adjusting the urine test, oral paraquat dose, treatment time and gastric lavage time, the Cox Proportional Hazard Model showed that the patients prognosis had statistical significance at the level of 6 mmol/L ≤ Lac 〈 8 mmol/L （ HR 11.96, 95 % CI 2.52 ～56.72 ） and Lac ≥ 8 mmol/L （ HR 7.83, 95 % CI 2.08 ～ 29.37 ）, compared with the level of 0 mmol/L ≤ Lae 〈 2 mmol/L of Lac （P 〈0.01 ）. The survival curves of patients under different Lae levels showed that the survival rate of patients also gradually decreased with the increase level of Lac, the difference was statistically significant （P 〈 0.01 ）. Conclusion The initial Lac level in acute oral paraquat poisoning is correlated with the prognosis of patients. The higher the Lae leve

关 键 词：急性百草枯中毒 血乳酸(Lac) 初始血乳酸水平 口服 

分 类 号：R595[医药卫生—内科学]