PSS联合cTnⅠ在诊断急性乌头碱中毒致心律失常中的预测价值研究  

Study on the predictive value of poisoning severity score combined with troponinⅠin the diagnosis of arrhythmias caused by acute aconitine poisoning

作　　者：段永春 李芳[1] 陶莉莉 许钰唯 廖睿 陈安宝[1] DUAN Yongchun;LI Fang;TAO Lili;XU Yuwei;LIAO Rui;CHEN Anbao(Department of Emergency Medicine,the Second Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650101,China)

机构地区：[1]昆明医科大学第二附属医院急诊内科,昆明650101

出　　处：《重庆医学》2020年第16期2706-2710,共5页Chongqing medicine

基　　金：云南省科技厅应用基础研究(昆明医科大学联合专项)[2017FE468(-251)];昆明医科大学第二附属人才培育计划(RCPYXM2017-3-04)。

摘　　要：目的探讨中毒严重程度评分(PSS)联合肌钙蛋白Ⅰ(cTnⅠ)在诊断急性乌头碱中毒(AAP)致心律失常中的预测价值,为临床早期决策提供依据。方法回顾性分析2013年5月至2019年6月该院急诊内科收治113例AAP患者相关资料,根据是否发生心律失常分为心律失常组和非心律失常组。收集入院时的PSS和cTnⅠ,分析二者与心律失常的相关性,采用受试者工作特征(ROC)曲线检测PSS、cTnⅠ预测心律失常的最佳截断值,并比较PSS、cTnⅠ及二者联合对诊断心律失常的预测价值。结果心律失常组PSS和cTnⅠ较非心律失组明显升高(P<0.05)。PSS、cTnⅠ与心律失常均呈正相关(P<0.05)。PSS>1分和cTnⅠ>0.1 ng/mL为最佳截断值。PSS、cTnⅠ及二者联合的ROC曲线下面积(AUC)分别是0.67(0.57,0.78)、0.71(0.62,0.81)和0.76(0.67,0.85),其中二者联合的AUC最大(P<0.05)。结论PSS联合cTnⅠ对诊断AAP致心律失常有一定的预测作用。Objective To investigate the predictive value of poison severity score(PSS)combined with cardiac troponinⅠ(cTnⅠ)in the diagnosis of arrhythmia induced by acute aconitine poisoning(APP),in order to provide guidelines for clinical care.Methods The data of 113 patients from May 2013 to June 2019 in hospital was retrospectively analyzed,and they were divided into the arrhythmia group and the non-arrhythmia group according to whether arrhythmia occurred.PSS and cTnⅠat admission were collected,and the correlation between the two indicators and arrhythmia was analyzed.The optimal cut-off value for predicting arrhythmia by PSS and cTnⅠwas detected by ROC curve,and the predictive value of PSS,cTnⅠand the combination of them in the diagnosis of arrhythmia was compared.Results PSS and cTnⅠin the arrhythmia group were significantly higher than those in the non-arrhythmia group(P<0.05).PSS and cTnⅠwere positively correlated with arrhythmias(P<0.05).PSS>1 point and cTnⅠ>0.1 ng/mL were the optimal truncation values.PSS,cTnⅠand their combined area under ROC curve(AUC)curves was 0.67(0.57,0.78),0.71(0.62,0.81)and 0.76(0.67,0.85),respectively,of which PSS and cTnⅠcombined AUC was the largest(P<0.05).Conclusion PSS combined with cTnⅠcould predict the diagnosis of arrhythmia induced by AAP.

关 键 词：乌头碱 中毒 心律失常 心性 中毒严重程度评分 肌钙蛋白Ⅰ 

分 类 号：R446.1[医药卫生—诊断学]