APACHE Ⅱ评分和纤维蛋白原、血淀粉酶与急性有机磷中毒病情及血液净化治疗预后的相关性  

Correlation between APACHEⅡscore,fibrinogen,serum amylase and acute organophosphorus poisoning and prognosis of blood purification treatment

作　　者：蔡晓培 刘洪波[1] 杨一红 李彩侠[1] 闫敏[1] CAI Xiao-pei;LIU Hong-bo;YANG Yi-hong(Department of Emergency,Fuyang People's Hospital,Fuyang Anhui 236000,China)

机构地区：[1]阜阳市人民医院急诊科,安徽阜阳236000

出　　处：《临床和实验医学杂志》2022年第15期1642-1645,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽省医学会急诊临床研究项目(编号:Ky2018014)。

摘　　要：目的 探讨急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分和纤维蛋白原(FIB)、血淀粉酶(AMS)与急性有机磷中毒病情及血液净化治疗预后的相关性。方法 回顾性分析2018年9月至2021年12月阜阳市人民医院收治的急性有机磷中毒患者78例,根据患者中毒情况分为轻度组(n=31)和中重度组(n=47),纳入同期健康人群50名为对照组。比较3组患者APACHE Ⅱ评分和FIB、AMS水平,采用Pearson分析其与患者病情的相关性。根据患者生存情况将患者分为生存组(n=59)和死亡组(n=19),记录两组患者年龄、性别、中毒时间、APACHE Ⅱ评分、并发症发生情况、FIB、AMS水平比较,并进行Logistic多因素回归分析。结果 中重度组APACHE Ⅱ评分为(26.65±4.36)分,高于轻度组[(18.68±2.05)分],差异有统计学意义(P<0.05);中重度组、轻度组AMS水平为(207.18±16.42)、(136.78±12.84) U/L,高于对照组[(98.57±10.54) U/L],且中重度组高于轻度组,差异均有统计学意义(P<0.05);中重度FIB水平为(3.71±0.92) g/L,高于对照组[(3.38±0.87) g/L],差异有统计学意义(P<0.05),轻度组与对照组比较,差异无统计学意义(P> 0.05)。Pearson分析APACHE Ⅱ、FIB、AMS与患者病情呈正相关性(r=0.850、0.837、0.875,P<0.001)。死亡组患者中毒时间、APACHE Ⅱ、FIB、AMS高于生存组,差异均有统计学意义(P<0.05);两组患者中毒程度差异有统计学意义(P<0.05)。Logistic多因素回归分析,中毒时间、APACHE Ⅱ、FIB、AMS、中毒程度是急性有机磷中毒血液净化治疗后患者死亡危险因素。结论 APACHE Ⅱ评分、FIB、AMS与急性有机磷中毒患者病情及血液净化治疗预后具有相关性,且患者中毒过长、重度中毒、健康状态不佳可影响临床治疗预后。Objective To investigate the correlation between acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ),fibrinogen(FIB),serum amylase(AMS)and the prognosis of acute organophosphorus poisoning.Methods A total of 78 patients with acute organophosphorus poisoning admitted to Fuyang People's Hospital from September 2018 to December 2021 were retrospectively analyzed and divided into a mild group(n=31)and a moderate-to-severe group(n=47)according to their poisoning conditions.In the control group,50 healthy people in the same period were included.APACHEⅡscore and FIB and AMS levels were compared among the three groups,and their correlation with the patient's condition was analyzed using Pearson correlation analysis.The patients were further divided into a survival group(n=59)and a death group(n=19)according to their survival status.Age,gender,poisoning time,APACHEⅡscore,occurrence of complications,FIB,and AMS levels were recorded and compared between the two groups,and logistic multivariate regression analysis was performed.Results The APACHEⅡscore of the moderate-severe group was(26.65±4.36)points,which was higher than that of the mild group[(18.68±2.05)points],the difference was statistically significant(P<0.05).The levels of AMS in the moderate-severe group and the mild group were(207.18±16.42),(136.78±12.84)U/L,which were higher than those in the control group[(98.57±10.54)U/L],and the moderate-severe group was higher than the mild group,the differences were statistically significant(P<0.05).The level of FIB in the moderate and severe group was(3.71±0.92)g/L,which was higher than that in the control group[(3.38±0.87)g/L],and the difference was statistically significant(P<0.05);there was no significant difference in the level of FIB between the mild group and the control group(P>0.05).APACHEⅡ,FIB,and AMS were positively correlated with the patient's condition by pearson analysis(r=0.850,0.837,0.875,P<0.001).The poisoning time,APACHEⅡ,FIB,and AMS in the death group were higher t

关 键 词：急性有机磷中毒 急性生理学与慢性健康状况评分系统Ⅱ 纤维蛋白原 血淀粉酶 

分 类 号：R595.4[医药卫生—内科学]