肌酐最大值和增长速率对毒蕈中毒患者预后的价值研究  

Predictive value of maximum serum creatinine value and growth rate in poisonous mushroom poisoning patients

作　　者：刘芳[1] 王雷 LIU Fang;WANG Lei(Department of Clinical Laboratory,the Affiliated Changsha Central Hospital,Hengyang Medical School,University of South China,Changsha,Hunan 410004,China)

机构地区：[1]南华大学附属长沙中心医院检验科,湖南长沙410004

出　　处：《中国医学工程》2022年第11期14-18,共5页China Medical Engineering

摘　　要：目的评估毒蕈中毒(PMP)后最大血清肌酐值(maxCr)和最大血清肌酐增长速率(Vmax)的预后价值。方法纳入在南华大学附属长沙中心医院接受相同治疗方案的110例毒蕈中毒患者。记录并计算所有患者的人口统计学变量、临床表现、相关实验室数据、maxCr和Vmax。此外,记录误食毒蕈后达到maxCr和Vmax的时间。结果幸存组(n=76)和死亡组(n=34)Vmax和maxCr比较,差异有统计学意义。死亡组患者达到Vmax的时间早于幸存组患者。Vmax的AUC为0.872(95%CI,0.798~0.934),最佳阈值为6.52μmol/(L·h)(敏感性为78.1%;特异性为82.4%)。maxCr的曲线下面积(AUC)为0.832(95%CI,0.763~0.891),最佳阈值为231.6μmol/L(敏感性为83.3%;特异性为68.1%)。Vmax和maxCr的AUC无统计学差异,但Vmax出现早于maxCr。结论maxCr和Vmax均具有独立的预测能力,可用于评估PMP患者预后。【Objective】To evaluate the prognostic value of the maximum serum creatinine value(maxCr)and the maximum serum creatinine growth rate(Vmax)after poisonous mushroom poisoning(PMP).【Methods】One hundred and ten cases of patients with poisonous mushroom poisoning(PMP)were included in the same treatment regimen in our hospital.Demographic variables,clinical manifestations,relevant laboratory data,maxCr,and Vmax were recorded and calculated for all patients.In addition,the time of reaching maxCr and Vmax after ingesting poisonous mushrooms was recorded.【Results】There were statistically significant differences in Vmax and maxCr between the survival group(n=76)and the death group(n=34).Patients in the death group reached Vmax earlier than those in the survival group.The AUC of Vmax was 0.872(95%CI,0.798–0.934),and the optimal threshold value was 6.52μmol/(L·h)(the sensitivity was 78.1%,the specificity was 82.4%).The AUC of maxCr was 0.832(95%CI,0.763–0.891),and the optimal threshold was 231.6μmol/L(the sensitivity was 83.3%,the specificity was 68.1%).There was no statistical difference in AUC between Vmax and maxCr,but Vmax appeared earlier than maxCr.【Conclusion】Both maxCr and Vmax have independent predictive ability and can be used to evaluate the prognosis of PMP patients.

关 键 词：毒蕈中毒 最大血清肌酐值 最大血清肌酐增长速率 预后 

分 类 号：R969[医药卫生—药理学]