全血细胞计数对有机磷和百草枯中毒患者的临床价值研究  

Clinical value of whole blood cell count in patients with organophosphorus and paraquat poisoning

作　　者：移军[1] 顾霞[1] 曹晓萍[1] 陈荣荣 孙明[2] YI Jun;GU Xia;CAO Xiao-ping;CHEN Rong-rong;SUN Ming(Department of Emergency,Second People's Hospital of Taizhou City,Taizhou 225500,China)

机构地区：[1]泰州市第二人民医院急诊科,江苏泰州225500 [2]南京鼓楼医院集团宿迁市人民医院,江苏宿迁223800

出　　处：《工业卫生与职业病》2021年第5期399-403,共5页Industrial Health and Occupational Diseases

基　　金：2018年度江苏省第五期“333工程”科研资助立项项目(BRA2018262)。

摘　　要：目的探讨全血细胞计数(Complete blood count, CBC)在有机磷(Organophosphorus, OPPs)和百草枯(Paraquat, PQ)中毒中的临床价值。方法选取2016年1月-2018年1月就诊于我院急诊,OPPs中毒患者70例,PQ中毒患者54例,健康志愿者65例,为研究对象。收集中毒患者药物干预前和健康对照组的CBC相关参数,比较分析OPPs轻度和重度中毒,PQ死亡组和存活组间相关参数差异;采用重要性投影(variable importance in projection, VIP)值评价CBC对OPPs或PQ中毒的识别能力;探讨CHE和PQ浓度与CBC的相关性。结果 OPPs重度中毒患者与轻度中毒患者比较,WBC、NE和PDW均明显升高,HGB、PLT、MPV均明显下降,差异均有统计学意义(P<0.05);PQ死亡组与PQ存活组相比,WBC、NE%、NE和PDW均有明显升高(P均<0.05),LY、LY%、HGB、PLT、MPV均明显下降(P均<0.05);OPPs患者中血CHE水平与WBC、NE呈明显的正相关,与HGB、PLT、MPV呈显著的负相关(P均<0.05),CHE水平与NE的r值为0.590;PQ患者血PQ浓度与WBC、NE和PDW呈明显的正相关,与HGB、PLT、MPV呈显著的负相关(P均<0.05),PQ浓度与PLT的r值为-0.415。结论 PQ和OPPs中毒患者CBC存在差异,WBC和NE均可反应病情及预后,NE升高对OPPs中毒的诊断及预后最有意义,PLT的降低对PQ中毒的诊断及预后最具意义。Objective To investigate the clinical value of Complete Blood Count(CBC) in the treatment of Organophosphorus(OPPs) and Paraquat(PQ) poisoning. Methods From January 2016 to January 2018,70 patients diagnosed with OPPs poisoning, 54 patients with PQ poisoning, and 65 healthy volunteers in the emergency department of a hospital were selected as research subjects.The CBC-related parameters of the patients before drug intervention and of the healthy control group were collected, and the differences in CBC-related parameters were analyzed between CBC-related parameters of the OPPs mild poisoning patients were analysed with that of severe patients, PQ death group and PQ survival group.The variable importance in projection(VIP) values in CBC to evaluate the ability of CBC to identify OPPs or PQ poisoning.In addition, the correlation was explored between CHE and PQ concentrations and CBC. Results Compared with mild poisoning patients, patients with severe OPPs had significantly higher WBC,NE and PDW(P<0.05),while HGB,PLT and MPV were significantly decreased(P<0.05).Compared with the PQ survival group, WBC,NE%,NE and PDW of the patients in PQ death group were significantly increased(P<0.05),while LY,LY%,HGB,PLT and MPV were significantly decreased(P<0.05).There was a significant positive correlation between blood CHE level and WBC and NE in patients with OPPs, but a significant negative correlation with HGB,PLT and MPV(P<0.05),and CHE level and NE r value was 0.590.The concentration of PQ in the middle blood was positively correlated with WBC,NE and PDW,but negatively correlated with HGB,PLT and MPV(P<0.05),and the RQ of PQ and PLT was-0.415. Conclusions The relevant parameters of CBC have a wide range of changes in PQ and OPPs poisoning patients.WBC and NE can reflect the condition and prognosis of PQ and OPPs poisoning patients, but NE elevation is the most meaningful for the prognosis of OPPs poisoning, and the PLT is decreased.The most significant for PQ poisoning.

关 键 词：全血细胞计数 有机磷 百草枯 中毒 

分 类 号：R595.4[医药卫生—内科学]