急性有机磷农药中毒患者血清KL-6、TGF-β水平与肺功能预后的相关性及影响预后的因素  

Correlation between Serum KL-6 and TGF-βLevels and Prognosis of Pulmonary Function in Patients with Acute Organophosphorus Pesticide Poisoning and Factors Affecting Prognosis

作　　者：王磊 程继伟 赵伟峰 WANG Lei;CHENG Ji-wei;ZHAO Wei-feng(Department of Emergency,Xinzheng People’s Hospital,Xinzheng 451150,China;Intensive Care Unit,Xinzheng People’s Hospital,Xinzheng 451150,China)

机构地区：[1]新郑市人民医院急诊科,河南新郑451150 [2]新郑市人民医院重症监护室,河南新郑451150

出　　处：《实用临床医学（江西）》2023年第5期10-14,共5页Practical Clinical Medicine

摘　　要：目的探讨急性有机磷农药中毒患者血清KL-6、TGF-β水平与肺功能预后的相关性,并对预后的影响因素进行分析。方法选取2019年2月至2023年1月于新郑市人民医院接受治疗的125例急性有机磷农药中毒患者为研究对象,根据有无呼吸衰竭将其分为呼吸衰竭组82例和非呼吸衰竭组43例。比较2组患者的血清唾液酸化糖链抗原(krebs von den Lungen-6,KL-6)、转化生长因子-β(transforming growth factor-β,TGF-β)水平及肺功能[包括用力肺活量(forced vital capacity,FVC)以及第1秒用力呼气容积(forced expiratory volume in1second,FEV1)水平];采用Pearson相关性分析患者血清KL-6、TGF-β水平与肺功能的相关性;根据预后情况将呼吸衰竭组患者亚分组为生存组54例和死亡组28例,分析影响患者预后的相关因素。结果呼吸衰竭组患者的血清KL-6、TGF-β水平均高于非呼吸衰竭组(P<0.05),FVC、FEV1水平均低于非呼吸衰竭组(P<0.05);血清KL-6与FVC(r=-0.687)、FEV1(r=-0.773)水平呈负相关性,血清TGF-β与FVC(r=-0.530)、FEV1(r=-0.584)水平呈负相关性(均P<0.05)。生存组的服农药量以及PaCO_(2)水平低于死亡组,KL-6、TGF-β、PaO_(2)、FVC以及FEV1水平均高于死亡组(P<0.05);多因素Logistics回归分析显示,服农药量(OR=0.929,P=0.045)、KL-6(OR=0.976,P<0.001)、TGF-β(OR=0.548,P=0.032)以及PaCO_(2)(OR=0.731,P=0.047)水平是导致患者死亡的危险因素。结论血清KL-6、TGF-β水平可预测急性有机磷农药中毒患者发生呼吸衰竭后的肺功能情况以及预后生存状况。Objective To explore the correlation between serum KL-6 and TGF-βlevels and prognosis of pulmonary function in patients with acute organophosphorus pesticide poisoning,and to analyze the factors influencing prognosis.Methods A total of 125 patients with acute organophosphorus pesticide poisoning treated in Xinzheng People’s hospital from February 2019 to January 2023 were divided into respiratory failure group(82 patients)and non-respiratory failure group(43 patients).Serum sialylated carbohydrate antigen Krebs von de Lungen-6(KL-6)and transforming growth factor-β(TGF-β)levels,forced vital capacity(FVC),and forced expiratory volume in one second(FEV1)were compared between the two groups.Pearson correlation was used to analyze the correlation between serum KL-6 and TGF-βlevels and lung function.According to the prognosis,respiratory failure group was subdivided into survival group(54 patients)and death group(28 patients),and the related factors affecting the prognosis were analyzed.Results Compared with the non-respiratory failure group,serum KL-6 and TGF-βlevels increased,and FVC and FEV1 decreased in the respiratory failure group(P<0.05).Both KL-6 and TGF-βlevels were negatively correlated with FVC(r=-0.687 and-0.530,respectively)and FEV1(r=-0.773 and-0.584,respectively)(P<0.05).Compared with the death group,pesticide intake and PaCO_(2) decreased,and KL-6,TGF-β,PaO_(2),FVC and FEV1 increased in the survival group(P<0.05).Multivariate logistic regression analysis showed that pesticide dose(OR=0.929,P=0.045),KL-6 level(OR=0.976,P<0.001),TGF-βlevel(OR=0.548,P=0.032)and PaCO_(2)(OR=0.731,P=0.047)were the risk factors leading to the death of the patients.Conclusion Serum KL-6 and TGF-βlevels can predict the pulmonary function and survival status of acute organophosphorus pesticide poisoning patients with respiratory failure.

关 键 词：急性有机磷农药中毒 呼吸衰竭 唾液酸化糖链抗原 转化生长因子-β 肺功能 

分 类 号：R595.4[医药卫生—内科学]