血清心型脂肪酸结合蛋白在急性一氧化碳中毒严重程度分级中的应用  

Application of serum H-FABP in severity classification of acute carbon monoxide poisoning

作　　者：王琳[1] 王玺凯 杜永锋[1] WANG Lin;WANG Xi kai;DU Yong feng(Xi'an Central Hospital,Xi'an 710003,China)

机构地区：[1]西安市中心医院,陕西西安710003

出　　处：《中国工业医学杂志》2020年第1期25-28,共4页Chinese Journal of Industrial Medicine

基　　金：陕西省重点研发计划项目——心型脂肪酸结合蛋白作为急性中毒严重程度分级标志物的研究(编号:2017SF 253)。

摘　　要：目的研究血清心型脂肪酸结合蛋白(H-FABP)水平在急性一氧化碳中毒(ACOP)患者严重程度分级中的临床意义。方法将2017年1月至2018年12月收治的资料完整的24例ACOP患者,根据《职业性急性化学物中毒的诊断总则》(GBZ 71-2013)分为轻度、中度和重度中毒组,同时予以序贯性脏器衰竭评分(SOFA),另选取同期健康体检的50名正常者作为对照组。各组均检测血清H-FABP含量,统计分析各组血清H-FABP和SOFA评分及其两者相关关系,采用受试者工作特征(ROC)曲线评估H-FABP在急性中毒严重程度分级中的价值。结果重度中毒组血清H-FABP和SOFA评分明显高于正常对照组、轻度中毒组和中度中毒组(P<005),血清H-FABP、 SOFA评分均与中毒程度呈正相关(r=0456,P<005;r=0674,P<005);ROC曲线分析显示,血清H-FABP评估急性中毒轻、中、重度的最佳临界值分别为219 ng/ml、 281 ng/ml和344 ng/ml。此外,ACOP患者发病24 h内H-FABP水平的AUC面积明显大于SOFA评分;发病>24 h, H-FABP水平的AUC面积小于SOFA评分。结论血清H-FABP水平随ACOP严重程度分级的提高而升高,可将其作为临床评估的参照指标;血清H-FABP对早期(≤24 h) ACOP诊断也有参考价值。Objective To investigate the clinical significance of serum heart-type fatty acid binding protein(H-FABP) in severity classification of acute carbon monoxide poisoning.Methods 24 acute carbon monoxide poisoning patients and 50 healthy volunteers in our hospital from January 2017 to December 2018 were collected, and were divided into three groups(mild, middle and severe groups) according to the national diagnosis of acute CO poisoning GBZ 71-2013, 50 healthy adults were collected as control group, the serum H-FABP and evaluated sequential organ failure assessment(SOFA) score of all the subjects were detected, and analyze the relationship between serum H-FABP and SOFA score of each group, ROC(receiver operating characteristic curve) was used to evaluate the value of serum H-FABP in acute poisoning severity classification.Results The results showed that the level of serum H-FABP and SOFA score of severe poisoning group was statistically higher in severe poisoning group than the all other groups(P<0 05), the serum H-FABP and SOFA score were also all positively correlated with the severity of poisoning(r= 0 456,P<0 05;r= 0 674,P<0 05). ROC curve analysis showed that the best critical values of serum H-FABP/monoxide poisoning patients(within 24 h), the AUC of serum H-FABP was larger than SOFA score, while serum H-FABP was less than SOFA score.Conclusion The results suggest that the level of serum H-FABP may rise with the severity of acute carbon monoxide poisoning, thereby could be used as a reference indicator for clinical evaluation, which might be a subsidiary index for early(within 24 h) evaluation of acute carbon monoxide poisoning as well.

关 键 词：急性一氧化碳中毒(ACOP) 血清心型脂肪酸结合蛋白(H-FABP) 序贯性脏器衰竭评分(SOFA) 受试者工作特征曲线(ROC) 

分 类 号：R595.1[医药卫生—内科学]