血清和肽素对急性一氧化碳中毒患者病情和预后的评估价值  

Value of serum copeptin in assessment of severity and prognosis of patients with acute carbon monoxide poisoning

作　　者：王静[1] 李薇[1] 李国慧[1] 逄利[1] WANG Jing;LI Wei;LI Guo-hui;PANG Li(Department of Emergency,the First Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院急诊科,长春市130021

出　　处：《广西医学》2018年第23期2789-2791,共3页Guangxi Medical Journal

基　　金：国家自然科学基金(81501653)

摘　　要：目的探讨血清和肽素对急性一氧化碳中毒(ACMP)患者病情和预后的评估价值。方法选取94例ACMP患者,分为轻度中毒组49例、中度中毒组25例、重度中毒组20例,其中预后不良组16例、预后良好组78例。检测并比较不同程度中毒患者中毒后24 h内的血清和肽素水平,分析和肽素水平与中毒程度的相关性。比较不同预后患者的血清和肽素水平,采用受试者工作特征曲线评价血清和肽素对预后不良的预测效能。结果轻、中、重度中毒各组的血清和肽素水平依次升高(均P <0. 05)。血清和肽素水平与中毒程度呈正相关(P <0. 05)。预后不良组的血清和肽素水平高于预后良好组(P <0. 05)。和肽素水平预测ACMP患者预后不良的曲线下面积为0. 853,最佳界值为41. 6 pmol/L时,敏感度为80. 1%、特异度为83. 8%。结论血清和肽素或可作为评估ACMP患者病情和预后的重要指标。Objective To investigate the value of serum copeptin in the assessment of severity and prognosis of the patients with acute carbon monoxide poisoning( ACMP). Methods Ninety-four patients with ACMP were enrolled. The patients were divided into mild poisoning group( n = 49),moderate poisoning group( n = 25) and severe poisoning group( n = 20),and were also divided into poor prognosis group( n = 16) and good prognosis group( n = 78). The serum copeptin levels were detected in all cases within 24 hours after poisoning and were compared among the patients with different severity,the correlation of copeptin level with the severity of poisoning was analyzed. The serum copeptin levels were compared between the patients with different prognosis,receiver operating characteristic curve was used to evaluate the efficiency of serum copeptin for predicting the poor prognosis. Results The serum copeptin level increased in the order of the mild,moderate and severe poisoning groups( all P < 0. 05). There was a positive correlation between the serum copeptin level and the severity of poisoning( P < 0. 05). The serum copeptin level of the poor prognosis group was higher than that of the good prognosis group( P < 0. 05). The area under the curve of copeptin level for predicting poor prognosis in ACMP patients was 0. 853 with an optimal cut-off value of 41. 6 pmol/L,and its sensitivity and specificity were 80. 1% and 83. 8% respectively. Conclusion Serum copeptin may be used as an important indicator to evaluate the severity and prognosis of patients with ACMP.

关 键 词：一氧化碳中毒 和肽素 严重程度 预后 

分 类 号：R595.1[医药卫生—内科学]