百草枯中毒患者营养生化指标的变化趋势  

Study on the trend of nutritional biochemical indexes in patients with paraquat poisoning

作　　者：孟兆华[1] 苑霖 宫玉[1] 姚冬奇[1] 朱铁英 高恒波[1] 田英平[1] Meng Zhaohua;Yuan Lin;Gong Yu;Yao Dongqi;Zhu Tieying;Gao Hengbo;Tian Yingping(Emergency Department,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院急诊科,石家庄050000

出　　处：《中华急诊医学杂志》2018年第9期1035-1039,共5页Chinese Journal of Emergency Medicine

基　　金：河北省2016年度医学科学研究重点课题计划（20160110）

摘　　要：目的观察百草枯中毒患者营养生化指标，分析比较患者营养状况并了解各指标变化趋势。方法选取2015年12月至2017年12月于河北医科大学第二医院急诊科就诊的104例急性百草枯中毒患者，对营养生化指标血清蛋白质（白蛋白、前白蛋白、总蛋白）和血清脂质（总胆固醇、三酰甘油、低密度脂蛋白）进行动态观察。观察时间点设置为：中毒患者就诊后即时（入院第1天）、入院第4、7、10、13、16天，30d后随访。以住院期间死亡为观察终点，存活大于30d为治愈，分为治愈组和死亡组。将两组患者入院第1天和第4天的营养生化指标通过t检验进行分析和比较。分析治愈组患者营养状况，通过重复测量方差分析，了解各指标随时间变化的趋势。结果入院第4天，两组患者各项指标较第1天显著下降，治愈组总蛋白（73．34±5．75）g／L降至（51．95±6．05）gm，t=20．34，P〈0.01；总胆固醇（4．37±0．98）mmol／L降至（3．03±1．01）mmol／L，t=7．56，P〈0.01。死亡组总蛋白（72．25±8．80）gm降至（49．07±5．48）g／L，t=12．38，P〈0.01；总胆固醇（4．38±0．88）mmol／L降至（2．51±1．07）mmol／L，t=7．94，P〈0.01。死亡组降低幅度更大，第4天两组指标相比，白蛋白、总蛋白、总胆固醇差异均有统计学意义（P〈0.05）。对治愈组患者人院16d内各指标的动态观察显示，患者经治疗后白蛋白和总蛋白水平回升缓慢仍低于正常值，但前白蛋白及脂质水平在入院10d后迅速回升。结论百草枯中毒严重影响患者营养状况，血清蛋白水平下降显著且不易恢复，应在治疗及时给予适当的营养支持。Objective To observe the nutritional biochemical indicators of paraquat poisoning patients, analyze and compare the nutritional status of patients and understand the changing trend of each indicator. Methods A total of 104 patients with acute paraquat poisoning who were admitted to the emergency department of the Second Hospital of Hebei Medical University from December 2015 to December 2017 were enrolled, and divided into the cure group （patients who survived 〉30 days） and the death group. Nutritional biochemical indicators including serum protein （ALB, PA, TP） and serum lipids （TCh, TG, LDL） were selected for dynamic observation. The observation time points were set as follows： immediate treatment of poisoned patients （day 1 on admission）, on day 4, 7,10, 13 and 16 after admission, and on day 30 after follow-up. The nutritional biochemical indicators of the two groups on day I and 4 were statistically analyzed and compared by t test. The nutritional status of the patients in the cure group was analyzed, and the Repeated Measures Anova was performed to understand the trend of each indicator over time. Results In the cure group, the TP level decreased from （73.34±5.75）g/L on day 1 to （51.95±6.05）g/L on day 4, t=20.34, P〈0.01, and the TCh level decreased from （4.37±0.98） mmol/L on day 1 to （3.03±1.01）mmol/L on day 4, t=-7.56, P〈0.01. In the death group, the TP level decreased from （72.25±8.80）g/L on day 1 to （49.07±5.48）g/L on day 4, t=12.38, P〈0.01, and the TCh level decreased from （4.38±0.88）mmol/L on day 1 to （2.51±1.07） mmol/L on day 4, t=7.94, P〈0.01. Compared with the cure group, serum levels of ALB, TP and TCh in the death group decreased greater from day 1 to day 4 （all P〈0.05）. In addition, dynamic observation of the indicators in the cure group within 16 days after admission showed that, after treatment, the levels of ALB and TP recovered slowly and were still lower than normal. While the levels of PA and lipid rose rapidly after 1

关 键 词：百草枯中毒 营养状况 蛋白质 脂质 

分 类 号：R595.4[医药卫生—内科学]