百草枯中毒患者血sCD14-T/mCD14水平与病情程度、APACHEⅡ评分有相关性  

Blood sCD14-T/mCD14 levels in patients with paraquat poisoning were correlated with the severity of the disease and APACHEⅡscore

作　　者：孔艳艳 吴晓飞[2] 陶言言[2] 秦永明 KONG Yan-yan;WU Xiao-fei;TAO Yan-yan;QIN Yong-ming(Department of Emergency Medicine,Bengbu Third People's Hospital,Bengbu Medical College,Anhui Bengbu 233000,China;Department of Emergency Medicine,the First Affiliated Hospital of Bengbu Medical College,Anhui Bengbu 233000,China)

机构地区：[1]蚌埠医学院附属蚌埠第三人民医院急诊内科,安徽蚌埠233000 [2]蚌埠医学院第一附属医院急诊内科,安徽蚌埠233000

出　　处：《内科急危重症杂志》2023年第3期222-225,共4页Journal of Critical Care In Internal Medicine

基　　金：安徽省教育厅重点课题(No:KJ2015B108by)。

摘　　要：目的:探讨百草枯中毒患者血可溶性CD14分子亚型(sCD14-T)/膜结合CD14(mCD14)水平变化以及与急性生理与慢性健康状况评估(APACHEⅡ)评分的相关性。方法:选取84例百草枯中毒患者,检测入院时血sCD14-T/mCD14水平、APACHEⅡ评分,根据《急性百草枯中毒诊治专家共识(2013)》,按病情程度,将患者分为轻度17例,中度42例,重度25例。比较不同病情程度患者血sCD14-T/mCD14水平、APACHEⅡ评分,并分析二者相关性,比较不同sCD14-T/mCD14水平、APACHEⅡ评分患者预后情况,分析血sCD14-T/mCD14水平、APACHEⅡ评分与预后的关系。结果:重度患者血sCD14-T、sCD14-T/mCD14水平、APACHEⅡ评分高于中度、轻度患者,且中度患者高于轻度患者,重度患者mCD14水平低于中度、轻度患者,且中度患者低于轻度患者(P均<0.05);以百草枯中毒重度为阳性样本,轻、中度为阴性样本,绘制受试者工作特征(ROC)曲线;外周血sCD14-T/mCD14水平联合APACHEⅡ评分评估重度百草枯中毒的曲线下面积(AUC)为0.898(95%CI:0.824~0.971);百草枯中毒患者sCD14-T/mCD14水平与APACHEⅡ评分呈正相关(P<0.05);sCD14-T/mCD14水平>3.22、APACHEⅡ评分>23分患者的生存率相较于sCD14-T/mCD14水平≤3.22、APACHEⅡ评分≤23分患者更低(P均<0.05);sCD14-T/mCD14水平、APACHEⅡ评分为百草枯中毒患者预后的独立危险因素(P均<0.05)。结论:百草枯中毒患者外周血sCD14-T/mCD14水平随病情加重逐渐升高,与APACHEⅡ评分呈正相关。Objective:To investigate the changes in blood soluble CD14 molecular subtype(sCD14-T)/membrane bound CD14(mCD14)levels in patients with paraquat poisoning and the correlation with the Acute Physiological Functioning and Chronic Health Status Rating SystemⅡ(APACHEⅡ)scores.Methods:A total of 84 patients with paraquat poisoning were selected.According to expert consensus on diagnosis and treatment of acute paraquat poisoning(2013),the patients were divided into mild(17 cases),moderate(42 cases)and severe(25 cases)groups according to the severity of the disease.The sCD14-T/mCD14 levels were determined and APACHEⅡscores were recorded on admission.The blood sCD14-T/mCD14 levels and APACHEⅡscores in patients with different degrees of disease were compared,and the correlation between sCD14-T/mCD14 levels and APACHEⅡscores was analyzed.The prognosis of patients with different sCD14-T/mCD14 levels and APACHEⅡscores was compared,and the relationship between sCD14-T/mCD14 levels,APACHEⅡscores and prognosis was analyzed.Results:Blood sCD14-T and sCD14-T/mCD14 levels,and APACHEⅡscores were higher in severe patients than in moderate and mild patients and higher in moderate patients than in mild patients,and mCD14 levels were lower in moderate and mild patients and lower in moderate patients than in mild patients(all P<0.05).The area under the curve(AUC)of peripheral blood sCD14-T/mCD14 levels combined with APACHEⅡscores to assess severe paraquat poisoning was 0.898(95%CI:0.824-0.971).sCD14-T/mCD14 level of paraquat poisoning patients was positively correlated with APACHEⅡscore(P<0.05).The survival rate of patients with sCD14-T/mCD14 level>3.22,APACHEⅡscore>23 was lower than that in the patients with sCD14-T/mCD14 level≤3.22,APACHEⅡscore≤23 points(P<0.05).sCD14-T/mCD14 level and APACHEⅡscore were independent risk factors for the prognosis of patients with paraquat poisoning(P<0.05).Conclusion:The level of sCD14-T/mCD14 in peripheral blood of patients with paraquat poisoning gradually increases with

关 键 词：百草枯中毒 血可溶性CD14分子亚型 膜结合CD14 急性生理与慢性健康状况评估评分 预后 

分 类 号：R595.4[医药卫生—内科学]