早期肾损伤指标检测对急性百草枯中毒患者预后的预测价值分析  

Prognostic value of early renal injury indexes in patients with acute paraquat poisoning

作　　者：徐明[1] 陈运超[1] 唐旭[1] XU Ming;CHEN Yunchao;TANG Xu(Department of Critical Care Medicine,Guangzhou 12th People´s Hospital,Guangzhou Guangdong 510620,China)

机构地区：[1]广州市第十二人民医院重症医学科,广东广州510620

出　　处：《中国急救复苏与灾害医学杂志》2023年第5期625-628,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：广东省医学科学技术研究基金项目(编号:A2017268)。

摘　　要：目的 探讨早期肾损伤指标检测对急性百草枯中毒(APP)患者预后的预测价值。方法 回顾性分析2019年6月—2021年6月广州市第十二人民医院收治的90例APP患者的临床资料,根据患者预后情况将经治疗后死亡的APP患者纳入死亡组(52例),存活的APP患者纳入存活组(38例);对比两组患者入院时与入院后3 d的胱抑素C(Cys-C)、血清肌酐(Scr)、视黄醇结合蛋白(RBP)、血乳酸(Lac)、β2微球蛋白(β2-MG)水平,分析患者入院时的β2-MG、Cys-C、RBP、Scr水平与APACHEⅡ评分、服毒量、Lac间的相关性。结果 入院时与入院后3 d死亡组患者的β2-MG、Cys-C、RBP、Scr、Lac水平均高于存活组(P<0.05);相关分析结果显示,早期APP患者的APACHEⅡ评分与β2-MG水平无显著相关性(r=0.143,P>0.05),与Cys-C、RBP、Scr水平呈正相关(r=0.282、0.386、0.179,P<0.05);早期APP患者的Lac水平与β2-MG、Cys-C、RBP、Scr水平呈正相关(r=0.158、0.179、0.288、0.199,P<0.05);早期APP患者的β2-MG、Cys-C、RBP、Scr水平与患者服毒量呈正相关(r=0.177、0.256、0.373、0.202,P<0.05)。结论β2-MG、Cys-C、RBP、Scr指标检测对APP患者病情及预后的预测价值较高,APP患者病情危重程度与β2-MG、Cys-C、RBP、Scr等指标表达水平均呈正相关。Objective To explore the prognostic value of early renal injury index in patients with acute paraquat poisoning(APP).Methods The clinical data of 90 APP patients in Guangzhou 12th People´s Hospital from June 2019 to June 2021 were retrospectively analyzed.According to the prognosis of patients,APP patients who died after treatment were set as the death group(52 cases)and APP patients who survived were set as the survival group(38 cases).The levels of cystatin C(Cys-C),serum creatinine(Scr),retinol binding protein(RBP),blood lactic acid(Lac)andβ2 microglobulin(β2-MG)level were compared,and the correlation between the levels ofβ2-MG,Cys-C,RBP,Scr at admission and APACHEⅡscore,poisoning dose and Lac was analyzed.Results The levels ofβ2-MG,Cys-C,RBP,Scr and Lac in death group were higher than those in the survival group at admission and 3 days after admission(P<0.05).Correlation analysis showed that APACHEⅡscores of patients with early APP had no significant correlation with the level ofβ2-MG(r=0.143,P>0.05),but was positively correlated with the levels of Cys-C,RBP and Scr(r=0.282,0.386,0.179,P<0.05);the level of Lac in patients with early APP was positively correlated with the levels ofβ2-MG,Cys-C,RBP and Scr(r=0.158,0.179,0.288 and 0.199,P<0.05);the levels ofβ2-MG,Cys-C,RBP and Scr in patients with early APP were positively correlated with the poisoning dose(r=0.177,0.256,0.373,0.202,P<0.05).Conclusion The detection ofβ2-MG,Cys-C,RBP and Scr has high predictive value for the condition and prognosis of APP patients,and the severity of APP patients is related to the levels ofβ2-MG,Cys-C,RBP and Scr.

关 键 词：急性百草枯中毒 血乳酸 胱抑素C 视黄醇结合蛋白 

分 类 号：R595.4[医药卫生—内科学]