急性有机磷中毒患者血清CRP/APN、IL-17与胆碱酯酶水平及临床结局的关系探究  

Study on the relationship between serum CRP/APN,IL-17 and cholinesterase levels and clinical outcomes in patients with acute organophosphate poisoning

作　　者：张燕 王红银 秦岚[1] ZHANG Yan;WANG Hongyin;QIN Lan(Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《中国急救复苏与灾害医学杂志》2023年第3期336-340,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：北京市卫生科技发展专项基金(编号:2018-4-096)。

摘　　要：目的探究急性有机磷中毒患者血清C反应蛋白(CRP)/脂联素(APN)、白细胞介素-17(IL-17)与胆碱酯酶水平及临床结局的关系。方法选取2016年8月—2021年7月首都医科大学附属北京友谊医院100例急性有机磷中毒患者作为观察组,另选取本院同期健康体检者100例作为对照组。比较两组血清CRP/APN、IL-17、胆碱酯酶水平,分析血清CRP/APN、IL-17、胆碱酯酶水平与病情程度的相关性,评价CRP/APN、IL-17、胆碱酯酶水平对重度急性有机磷中毒的评估价值,分析CRP/APN、IL-17与胆碱酯酶水平的关系,比较不同临床结局患者CRP/APN、IL-17水平,分析CRP/APN、IL-17水平与临床结局的关系。结果观察组轻度、中度、重度患者血清CRP/APN、IL-17水平均高于对照组,胆碱酯酶水平低于对照组,差异有统计学意义(P<0.05);急性有机磷中毒患者血清CRP/APN、IL-17水平与病情程度呈正相关关系,胆碱酯酶水平与病情程度呈负相关关系(P<0.05);绘制受试者工作特征(ROC)曲线,结果显示,CRP/APN、IL-17、胆碱酯酶水平单独评估重度急性有机磷中毒的曲线下面积(AUC)分别为0.727、0.799、0.753,三者联合评估重度急性有机磷中毒的AUC为0.886,最佳敏感度为82.35%,特异度为81.82%,较三者单独评估价值高;急性有机磷中毒患者血清CRP/APN、IL-17水平与胆碱酯酶水平呈负相关关系(P<0.05);100例急性有机磷中毒患者住院期间病死15例,其中病死患者血清CRP/APN、IL-17水平均高于生存患者,差异有统计学意义(P<0.05);Logistic回归分析,CRP/APN、IL-17水平均与急性有机磷中毒患者临床结局独立相关(P<0.05)。结论急性有机磷中毒患者血清CRP/APN、IL-17水平明显升高,且与胆碱酯酶水平及临床结局有关,可作为该病病情评估及预后预测的指标。Objective To explore the relationship between serum C-reactive protein(CRP)/adiponectin(APN),interleukin-17(IL-17),and cholinesterase levels and clinical outcomes in patients with acute organophosphate poisoning.Methods A total of 100 patients with acute organophosphate poisoning in our hospital from August 2016 to July 2021 were selected as the observation group,and 100 cases of physical examinations collected in our hospital during the same period were selected as the control group.The serum CRP/APN,IL-17,and cholinesterase levels were compared between the two groups,and the correlation between the serum CRP/APN,IL-17,and cholinesterase levels and the severity of the disease was analyzed,and the CRP/APN,IL-17,and cholinesterase levels were evaluated.The evaluation value of alkaline esterase levels for severe acute organophosphate poisoning,analysis of the relationship between CRP/APN,IL-17 and cholinesterase levels,comparison of CRP/APN,IL-17 levels in patients with different clinical outcomes,analysis of CRP/APN,The relationship between IL-17 levels and clinical outcomes.Results The levels of serum CRP/APN and IL-17 in the observation group of mild,moderate,and severe patients were higher than those of the control group,and the cholinesterase levels were lower than that of the control group,the difference was statistically significant(P<0.05);acute organophosphate Serum CRP/APN and IL-17 levels of poisoned patients were positively correlated with the severity of the disease,and cholinesterase levels were negatively correlated with the severity of the disease(P<0.05).The receiver operating characteristic(ROC)curve was drawn,and the results showed that the area under the curve(AUC)of CRP/APN,IL-17,and cholinesterase levels for evaluating severe acute organophosphate poisoning were 0.727,0.799,0.753,respectively.The AUC of the combined assessment of severe acute organophosphate poisoning was 0.886,the best sensitivity was 82.35%,and the specificity was 81.82%,which was higher than those of the three independent a

关 键 词：急性有机磷中毒 C反应蛋白 脂联素 白细胞介素-177 胆碱酯酶 病情程度 临床结局 

分 类 号：R595.4[医药卫生—内科学]