MHR和SII早期联合检测对急性一氧化碳中毒患者病情及预后的评估  

Evaluation of the condition and prognosis of patients with acute carbon monoxide poisoning by early combined detection of monocyte count to high-density lipoprotein ratio and systemic immune inflammatory index

作　　者：齐洪娜[1] 李佳[1] 宫平 米晓璐 王园园[1] 肖青勉[1] 王维展[1] 王璞[1] QI Hongna;LI Jia;GONG Ping;MI Xiaolu;WANG Yuanyuan;XIAO Qingmian;WANG Weizhan;WANG Pu(Emergency Department,Harrison International Peace Hospital Affiliated to Hebei Medical University,Hengshui Hebei 053000,China)

机构地区：[1]河北医科大学哈励逊国际和平医院急救医学部,河北衡水053000

出　　处：《中国急救复苏与灾害医学杂志》2024年第4期496-500,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：衡水市科学技术研究与发展计划项目(编号:2021014077Z)。

摘　　要：目的分析单核细胞与高密度脂蛋白胆固醇比值(MHR)、系统性免疫炎症指数(SII)在急性一氧化碳中毒(ACOP)患者中变化,探讨其早期联合检测对ACOP患者的病情及预后的评估。方法选取2019年1月—2023年1月在河北医科大学哈励逊国际和平医院急救医学部收治的ACOP患者120例,根据患者病情严重程度将其分为轻度中毒组30例、中度中毒组35例和重度中毒组55例;根据患者是否发生急性一氧化碳中毒迟发性脑病(DEACMP)情况分为DEACMP组17例和预后良好组103例;同期健康体检者30例作为对照组。所有患者均在入院时,对照组于体检时,检测MHR、SII、白细胞介素-18(IL-18)和C反应蛋白(CRP)的变化,记录患者60 d内DEACMP发生情况。通过Logistic回归分析ACOP发生DEACMP的独立危险因素。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估MHR和SII对ACOP患者发生DEACMP的预测价值。结果入院时,不同中毒程度患者MHR、SII、IL-18和CRP水平均高于对照组,中度高于轻度,重度高于中度、轻度,均有统计学差异(P<0.05)。3组患者DEACMP发生率分别为0,5.71%和27.27%,有统计学差异(χ^(2)=14.777,P=0.001)。相关分析结果显示,ACOP患者中毒程度与DEACMP发生率呈正相关(r=0.648,P=0.000)。Logistic回归分析结果显示,MHR、SII水平升高均是ACOP患者发生DEACMP的危险因素(OR=7.757、5.169,均P<0.01)。入院时MHR、SII、IL-18、CRP及MHR+SII预测发生DEACMP的AUC分别为0.840、0.862、0.771、0.706和0.899,MHR和SII联合应用预测能力优于MHR、SII、IL-18和CRP(P<0.05)。结论MHR和SII是ACOP患者发生DEACMP的独立危险因素,MHR和SII早期联合检测有助于ACOP患者病情和预后的评估。Objective To analyze the changes of monocyte count to high-density lipoprotein ratio(MHR),systemic immune-inflammation index(SII)in patients with acute carbon monoxide poisoning(ACOP).To explore the evaluation of its early combined detection on the condition and prognosis of ACOP patients.Methods The 120 patients with ACOP treated in our hospital from Jan.2019 to Jan.2023 were selected:mildly poisoned group(30 cases),moderately poisoned group(35 cases)and severely poisoned group(55 cases).According to the prognosis of the patients,they were divided into 17 cases in delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)group and 103 cases in good prognosis group.Another 30 healthy persons were selected as control group.Venous blood were collected on physical examination of the control group,venous blood were collected on all patients at admission to detect MHR,SII,interleukin-18(IL-18)and C-reactive protein(CRP)levels.The occurrence of DEACMP in 60 days were recorded.Logistic regression was used to analyze the independent risk factors of DEACMP in ACOP.Draw the receiver operating characteristic(ROC)curve,calculate the area under the curve(AUC),and evaluate the predictive value of MHR and SII on the occurrence of DEACMP in patients with ACOP.Results At the time of admission,the levels of MHR,SII,IL-18 and CRP in patients with ACOP were higher than those in the control group,and moderate than mild,severe than moderate,mild,the difference is statistically significant(P<0.05).The incidence of DEACMP in the three groups was 0,5.71%and 27.27%respectively,and the differences were statistically significant(χ^(2)=14.777,P=0.001).The results of correlation analysis showed that the degree of poisoning in patients with ACOP was positively correlated with the incidence of DEACMP(r=0.648,P=0.000).Logistic regression analysis results showed that elevated levels of MHR and SII are risk factors for DEACMP in patients with ACOP(OR=7.757,5.169,all P<0.01).The AUC of MHR,SII,IL-18,CRP and MHR+SII at admission predicted

关 键 词：一氧化碳中毒 单核细胞与高密度脂蛋白胆固醇比值 系统性免疫炎症指数 急性一氧化碳中毒迟发性脑病 早期 预后 

分 类 号：R595.1[医药卫生—内科学]