S100A12水平与急性百草枯中毒患者分型及预后的相关性分析  

Correlation analysis between the level of S100A12 and the classification and prognosis of the patients with acute paraquat poisoning

作　　者：王雪 孙伟[2] 温军祥 李爱英[3] 史有奎[2] Wang Xue;Sun Wei;Wen Jun-xiang;Li Ai-ying;Shi You-kui(Weifang Medical College,Weifang 261053,China)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261053 [2]潍坊医学院附属医院急诊科,山东潍坊261031 [3]潍坊医学院附属医院眼科中心,山东潍坊261031

出　　处：《中国急救医学》2020年第4期329-333,共5页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨百草枯(PQ)中毒患者血清S100A12水平与其严重程度和死亡预后的相关性.方法 选取2015年1月至2019年3月潍坊医学院附属医院急诊重症监护室收治的急性百草枯中毒患者59例为百草枯中毒组,并选取同期健康查体者20例作为对照组.根据入院时百草枯中毒患者受累脏器损害程度及尿百草枯浓度分为轻度组(n=4)、中度组(n=15)、重度组(n=40),随访30 d预后结局分为生存组(n=12)和死亡组(n=47).记录所有研究对象的基本信息,并测定所有研究对象血清S100A12水平及相关检测指标.结果 与对照组比较,百草枯中毒组患者血清S100A12水平明显升高(ng/mL:77.93±10.30 vs.209.18±47.39),差异有统计学意义(P<0.05);对不同严重程度的急性百草枯中毒组进行比较,重度组的口服百草枯剂量、入院时血百草枯浓度及血清S100A12水平、白细胞计数(WBC)、急性生理学与慢性健康状况Ⅱ评分(APACHEⅡ评分)、动脉血二氧化碳分压(PCO2)均高于中度组,中度组高于轻度组,差异均有统计学意义(P<0.05);相关分析表明,百草枯中毒组血清S100A12水平与口服百草枯剂量、入院时血百草枯浓度、WBC、APACHEⅡ评分、PCO2呈正相关(P<0.05);Logistic回归分析表明,口服百草枯剂量、血百草枯浓度、血清S100A12水平是急性百草枯中毒患者死亡的独立危险因素;受试者工作特征曲线(ROC曲线)分析显示,血清S100A12水平对急性百草枯中毒患者的病情转归有预测价值,可作为急性百草枯中毒患者30 d生存预后的辅助性评估指标.结论 急性百草枯中毒患者血清S100A12水平明显升高,且与其严重程度密切相关,可作为评估患者严重程度及30 d预后结局的有效指标.Objective To investigate the correlation between serum S100A12 level and the severity and prognosis in the patients with paraquat(PQ)poisoning.Methods From January 2015 to March 2019,59 patients with acute paraquat poisoning were admitted to the Emergency Intensive Care Unit of the Affiliated Hospital of Weifang Medical College.The patients with paraquat poisoning were divided into three groups according to the degree of organ damage and the concentration of paraquat in urine at admission.At the same time,the patients were divided into survival group(n=12)and dead group(n=47)according to the prognostic outcomes after 30-day follow-up.The basic information of all subjects was recorded,and the serum level of SI00A12 and related indicators were measured.Results Compared with the control group,the serum level of S100A12 was significantly higher in severe paraquat poisoning group(ng/mL:77.93±10.30 vs.209.18±47.39,P<0.05).The acute paraquat poisoning groups with different severity compared with each other,the oral dose of paraquat,the serum concentration of paraquat at admission,the serum level of S100A12,white blood cell count(WBC),APACHE Ⅱ score and PC02 in severe paraquat poisoning group were higher than those in moderate group,and were higher in mederate group compared with mild group(P<0.05).The correlation analysis showed that the level of serum S100A12 in paraquat poisoning group was positively correlated with oral paraquat dose,serum paraquat concentration at admission,WBC,APACHE Ⅱ score and PC02(P<0.05).Logistic regression analysis showed that oral paraquat dose,serum paraquat concentration and serum S100A12 were independent risk factors for death in the patients with acute paraquat poisoning.ROC curve analysis showed that the level of serum S100A12 had predictive value for the prognosis of patients with acute paraquat poisoning,and could be used as an assistant prognostic index for 30-day prognosis of patients with acute paraquat poisoning.Conclusion The level of serum S100A12 in the patients with acute

关 键 词：百草枯(PQ) S100A12 严重程度 预后 

分 类 号：R595.4[医药卫生—内科学]