外周血淀粉酶、胆碱酯酶及动静脉二氧化碳分压差/动静脉氧含量差对有机磷农药中毒预后的预测价值  

Predictive value of peripheral amylase,cholinesterase and differential carbon dioxide pressure/arteriovenous oxygen content on the prognosis of organophosphorus pesticide poisoning

作　　者：陈建峰 陶敏 薛学丽 CHEN Jian-feng;TAO Min;XUE Xue-li(Department of Comprehensive Care Unit,Yuncheng Central Hospital,Yuncheng Shanxi 044000,China;Department of Clinical Laboratory,Yuncheng Central Hospital,Yuncheng Shanxi 044000,China;Department of Obstetrics and Gynecology,Affiliated Hospital of Yuncheng Vocational College of Nursing,Yuncheng Shanxi 044000,China)

机构地区：[1]运城市中心医院综合监护室,山西运城044000 [2]运城市中心医院检验科,山西运城044000 [3]运城市护理职业学院附属医院妇产科,山西运城044000

出　　处：《临床和实验医学杂志》2024年第22期2423-2427,共5页Journal of Clinical and Experimental Medicine

基　　金：山西省面上青年基金项目(编号:201901D211332)。

摘　　要：目的探究外周血淀粉酶、胆碱酯酶及动静脉二氧化碳分压差/动静脉氧含量差[P(v-a)CO_(2)/C(a-v)O_(2)]对有机磷农药中毒预后的预测价值。方法回顾性选取2019年2月至2023年2月在运城市中心医院接受治疗的300例有机磷农药中毒患者作为研究对象。记录患者在住院期间的生存情况,将36例住院期间死亡的患者纳入死亡组,其他264例患者纳入生存组。收集两组患者的年龄、体重指数、性别、就医时间、有机磷农药种类、有机磷农药服用量、意识恢复时间、机械通气时间,同时记录休克发生率。分析入院当天患者外周血淀粉酶、胆碱酯酶及相关氧代谢指标的差异,并探究其对患者预后死亡的预测价值。结果生存组和死亡组在年龄、体重指数、性别、就医时间、意识恢复时间方面比较,差异均无统计学意义(P>0.05);死亡组服用有机磷农药量≥100 mL、机械通气时间≥3 h、休克发生率占比均高于生存组,差异均有统计学意义(P<0.05)。死亡组患者的外周血淀粉酶水平为(215.26±22.08)U/L,高于生存组[(189.26±23.02)U/L],胆碱酯酶水平为(8.02±4.12)kU/L,低于生存组[(11.02±3.65)kU/L],差异均有统计学意义(P<0.05)。死亡组患者的乳酸、P(v-a)CO_(2)、C(a-v)O_(2)、P(v-a)CO_(2)/C(a-v)O_(2)水平分别为(5.11±1.78)mmol/L、(7.78±1.54)mmHg、(3.66±0.78)mL、2.44±0.51,均高于生存组[(4.15±1.02)mmol/L、(6.15±1.78)mmHg、(3.02±1.16)mL、2.21±0.67],差异均有统计学意义(P<0.05)。经多因素Logistic回归分析可知,淀粉酶、胆碱酯酶、乳酸、P(v-a)CO_(2)、P(v-a)CO_(2)/C(a-v)O_(2)均是影响患者预后死亡的危险因素(P<0.05)。受试者操作特征(ROC)曲线结果显示,淀粉酶、胆碱酯酶、乳酸、P(v-a)CO_(2)、P(v-a)CO_(2)/C(a-v)O_(2)对患者预后死亡具有一定预测价值,其曲线下面积(AUC)值分别为0.848、0.740、0.749、0.758、0.714。结论外周淀粉酶、胆碱酯酶及P(v-a)CO_(2)/C(a-v)O_(2)能�Objective To explore the predictive value of peripheral blood amylase,cholinesterase and arteriovenous carbon dioxide partial pressure difference/arteriovenous oxygen content difference[P(v-a)CO_(2)/C(a-v)O_(2)]on the prognosis of organophosphorus pesticide poisoning.Methods A total of 300 patients with organophosphorus pesticide poisoning who were treated in Yuncheng Central Hospital from February 2019 to February 2023 were retrospectively selected as the study subjects.The survival of patients during hospitalization was recorded.Thirty-six patients who died during hospitalization were included in the death group,and the other 264 patients were included in the survival group.The age,body mass index,gender,medical time,organophosphorus pesticide type,organophosphorus pesticide dosage,consciousness recovery time,mechanical ventilation time of the two groups were collected,and the incidence of shock was recorded.The differences in peripheral blood amylase,cholinesterase and related oxygen metabolism indicators on the day of admission were analyzed,and the predictive value of patient prognostic death was explored.Results There were no statistically significant differences in age,body mass index,gender,medical time,organophosphorus pesticide type and consciousness recovery time between the survival group and the death group(P>0.05);the proportion of organophosphorus pesticide dosage≥100 mL,mechanical ventilation time≥3 h and shock incidence in the death group were higher than those in the survival group,and the differences were statistically significant(P<0.05).The peripheral blood amylase level of the death group was(215.26±22.08)U/L,which was higher than that of the survival group[(189.26±23.02)U/L],and the cholinesterase level was(8.02±4.12)kU/L,which was lower than that of the survival group[(11.02±3.65)kU/L],the differences were statistically significant(P<0.05).The levels of lactic acid,P(v-a)CO_(2),C(a-v)O_(2) and P(v-a)CO_(2)/C(a-v)O_(2) in the death group were(5.11±1.78)mmol/L,(7.78±1.54)mmHg,(3.66

关 键 词：淀粉酶类 胆碱酯酶类 预后 动静脉二氧化碳分压差/动静脉氧含量差 有机磷农药中毒 

分 类 号：R595.4[医药卫生—内科学]