急性百草枯中毒早期预后评价方法的构建

李同平; 何成; 尹德胤; 张雨; 陈统; 张垒

doi:10.13201/j.issn.1009-5918.2017.04.004

急性百草枯中毒早期预后评价方法的构建

- 南阳市中医院急诊科南阳市中毒诊疗中心(河南南阳, 473000)

详细信息

通讯作者: 李同平, E-mail:jacklyn@126.com

中图分类号: R595.4

收稿日期: 2017-01-20

Establishment of evaluation method for early prognosis of acute paraquat poisoning

- Department of Emergency, Nanyang Hospital of Traditional Chinese Medicine, the Center of Diagnosis and Treatment of Poisoning of Nanyang City, Nanyang 473000, China

More Information

Corresponding author: LI Tongping, E-mail: jacklyn@126.com

Received Date: 20 January 2017

摘要

摘要: 目的: 探讨构建急性百草枯(PQ)中毒早期预后评价方法。方法: 在APACHEⅡ急性生理学评分、年龄评分和慢性健康状况评分基础上,增加服毒量、尿检PQ浓度、白细胞计数(WBC)、碱剩余(BE)绝对值及服毒-入院时间5个指标的评分,构建急性PQ中毒预后评价方法。建立回归方程,把患者评分值代入回归方程,计算患者死亡风险,与实际病死率比较以验证评价方法的可靠性。结果: 71例患者通过评价方法评分为14~46分,平均(31.01±9.02)分。存活组为(20.72±3.86)分,死亡组为(36.61±5.27)分。Logistic回归分析后得出死亡风险方程:Ln[R/(1-R)]=-32.37+1.172×评分值。将患者评分代入死亡风险方程,计算死亡风险与实际病死率相比,二者接近。结论: 构建的急性PQ中毒早期预后评价方法评分对于患者预后预测效果良好。
- 急性百草枯中毒 /
- 预后 /
- 评价方法
Abstract: Objective: To investigate how to establish the evaluation method of early prognosis of acute paraquat poisoning. Method: On the basis of APACHE Ⅱ acute physiology score,age grade and chronic health condition score,the scores of 5 indexes such as the first routine detection of urinary PQ concentration,blood leukocyte count,the absolute value of base excess (BE) in arterial blood and poison-admission time,oral poison quantity were added to establish the evaluation method of acute paraquat poisoning.The Logistic regression of the patient's score with whether death was analyzed,the corresponding regression equation was set up,then the score was set into the regression equation,the risk factor of death was calculated,so as to verify the reliability of scoring system. Result: The score of 71 patients was 14 to 46 points,which was evaluated by the evaluation system.The average score was (31.01±9.02) points.The average score of the survival group was (20.72±3.86) points,while the death group was (36.61±5.27).The Logistic regression of the patient's score with whether death was analysised,regression equation:Ln[R/(1-R)]=-32.37+1.172* score.The score was set back into regression equation,it was found that the new evaluation system can be a good predictor of prognosis of patients with acute paraquat poisoning. Conclusion: The early prognostic evaluation method of acute paraquat can effectively predict the prognosis of acute paraquat poisoning.
- acute paraquat poisoning /
- prognosis /
- evaluation method

HTML全文

参考文献(5)

[1]	王欢, 俞同福, 张伟, 等.百草枯中毒患者早期胸部CT表现对预后的评估[J].南京医科大学学报 (自然科学版), 2015, 35 (2):234-236.
[2]	百草枯中毒诊断与治疗"泰山共识"专家组, 菅向东.百草枯中毒诊断与治疗"泰山共识" (2014)[J].中华危重病急救医学, 2015, 27 (4):297-297.
[3]	何成, 尹德胤, 李同平, 等.急性百草枯中毒的早期预后因素分析[J].临床急诊杂志, 2015, 16 (12):970-972.
[4]	Gawarammana I B, Buckley N A.Medical management of paraquat ingestion[J].Br J Clin Pharmacol, 2011, 72 (5):745-757.
[5]	孙裕强, 刘志.血浆定量及尿液定性检测百草枯浓度对急性百草枯中毒患者预后的早期评估价值[J].中华危重病急救医学, 2016, 28 (10):886-890.