目的 探讨百草枯(PQ)中毒患者血清磷水平与患者死亡预后的相关性.方法 回顾性分析在南京军区南京总医院急诊重症监护室确诊为急性百草枯中毒58例患者临床资料,根据临床预后分为死亡组(n=46)和生存组(n=12),比较2组患者血清磷水平以及其他临床相关指标间的差异性,并通过ROC曲线分析、相关性分析、Logistic回归分析评估血清磷水平与患者28 d死亡预后的相关性.结果 死亡组患者的血清磷水平明显低于生存组患者[(0.34±0.03)mmol/L vs(0.65±0.07)mmol/L,P<0.05];血清磷水平与28d死亡事件发生存在明显负相关(r=-0.524,P<0.05);ROC曲线分析示血清磷、APACHEII评分和百草枯口服量对死亡预后的AUC分别为0.737、0.683和0.724;Logistic回归分析血清磷[(≤0.032 mmol/L)OR=1.48,95%CI 0.82~3.13,P<0.05]和百草枯口服量[(≥15.8 mL)OR=2.12,95%CI 0.79~5.07,P<0.05]为百草枯中毒患者死亡发生的独立危险因素.结论 百草枯中毒患者早期血清磷水平与患者28 d死亡率密切相关,可作为评估患者预后的有效指标.%Objective To discuss and analyze the correlation between serum phosphorus levels and 28-day mortality in pa-tients with acute paraquat poisioning. Methods Fifty-eight patients with acute PQ poisioning were enrolled in this study. Based on the results of 28-day mortality, all the patients were divided into two groups:dead group ( n=46) and survival group ( n=12) . Com-pare the serum levels of phosphorus and other clinical records, and through ROC curve, correlation analysis and regression analysis were used to estimate the association between serum phosphorus levels and 28-day mortality. Results The levels of serum phosphorus in death group were significantly longer than those of in survival group [(0. 34±0. 03) mmol/L vs (0. 65±0. 07) mmol/L, P<0. 05] . Correlation analysis showed levels of phosphorus were negative correlation with 28-day death ( r=-0. 524, P<0. 05) . ROC a-nalysis showed that the AUC of serum phosphorus, APACHE II score and PQ dosage were0. 737, 0. 683 and 0. 724 respectively. Logis-tic regression analysis showed PQ intoxication dosage (≥15. 8 mL) ( OR=2. 12, 95%CI 0. 79-5. 07, P<0. 05) and serum phosphorus levels (≤0. 032 mmol/L) ( OR=1. 48, 95%CI 0. 82-3. 13, P<0. 05) were independently risk factors for death by PQ poisoning. Conclusion The serum phosphorus is related with 28-day mortality in acute paraquat poisioning patients.
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