血清肾上腺髓质素前体在急性中毒患者中的应用分析  

Analysis of the application of serum precursor adrenomedullin in acute intoxication

作　　者：周峰[1] 刘志祯[1] 蔡华忠[1] 张浩[1] ZHOU Feng;LIU Zhizhen;CAI Huazhong;ZHANG Hao(Department of Emergency,the Affliated Hospital of Jiangsu Univesity,Zhenjiang,Jiangsu,212001,China)

机构地区：[1]江苏大学附属医院急诊科,江苏镇江212001

出　　处：《临床急诊杂志》2018年第9期634-637,共4页Journal of Clinical Emergency

摘　　要：目的:探讨血清肾上腺髓质素前体(pro-ADM)对急性中毒患者病情评估的应用价值。方法:检测我院98例中毒患者(中毒组)和30例对照组的血清pro-ADM,并对中毒患者进行入院的APACHEⅡ评分。根据30d预后情况将中毒组分为死亡组(18例)、存活组(80例),比较中毒组与对照组的血清pro-ADM,并比较死亡组与中毒组、对照组的血清pro-ADM及APACHEⅡ评分,将中毒患者血清pro-ADM及APACHEⅡ评分进行相关性分析。采用受试者工作曲线(ROC)进行血清pro-ADM及APACHEⅡ评分在中毒患者预后分析。结果:(1)死亡组患者的pro-ADM及APACHEⅡ评分明显高于存活组(P<0.01),血清pro-ADM与APACHEⅡ评分呈正相关(r=0.625,P<0.01);(2)pro-ADM的AUC为0.794,95%可信区间为0.687~0.902,APACHEⅡ评分AUC为0.725,95%可信区间0.598~0.852;(3)ROC曲线中,pro-ADM截断值为1.99,敏感度0.833,特异度0.725,APACHEⅡ评分截断值14.5,敏感度0.778,特异度0.487。结论:急性中毒患者血清pro-ADM水平升高,联合检测pro-ADM和APACHEⅡ评分对急性中毒患者预后有一定的应用价值。Objective：To explore the application value of serum precursor adrenomedullin（pro-ADM）in the assessment of patients with acute poisoning.Method：The serum pro-ADM of 98 cases of intoxication patients and 30 control groups in our hospital were measured and the APACHE Ⅱscore of the intoxication patients was evaluated.The serum pro-ADM levels of the poisoning group and the control group were compared.The serum pro-ADM and APACHE Ⅱ scores of the death group,the poisoning group and the control group were compared.The correlation between serum pro-ADM and APACHE Ⅱ scores of the poisoning patients was analyzed.The outcome of serum pro-ADM and APACHE Ⅱ scores in patients with poisoning was analyzed with the subjects＇ working curve（ROC）.Result：（1）The scores of pro-ADM and APACHE Ⅱ in the death group were significantly higher than those in the survival group（P〈0.01）,Positive correlation was found between serum pro-ADM and APACHE Ⅱscore（r=0.625,P〈0.01）;（2）Under the ROC curve,the AUC of pro-ADM is 0.794,the 95% confidence interval is 0.687-0.902,the APACHE Ⅱ score AUC is 0.725,and the 95% confidence interval 0.598-0.852;（3）In the ROC curve,the truncated value of pro-ADM was 1.99,the sensitivity was 0.833,the specificity was 0.725,the truncated value of APACHE Ⅱ score was 14.5,the sensitivity was 0.778,and the specificity was 0.487.Conclusion：The level of serum pro-ADM in patients with acute poisoning is higher.The combined detection of pro-ADM and APACHE Ⅱ score has a certain value in the prognosis of patients with acute poisoning.

关 键 词：肾上腺髓质素前体 中毒 预后 

分 类 号：R595[医药卫生—内科学]