ALB和COP及CLI在百草枯中毒合并ARDS诊断及预后的意义

崔文华; 宋林超; 韩翡

doi:10.13201/j.issn.1009-5918.2020.07.013

ALB和COP及CLI在百草枯中毒合并ARDS诊断及预后的意义

- 潍坊市益都中心医院重症医学科(山东潍坊, 262500)

详细信息

通讯作者: 崔文华,E-mail:wenhuacui@163.com

中图分类号: R595

收稿日期: 2020-05-13

Clinical value of ALB and COP and CLI for predicting and prognosis of ARDS secondary to paraquat poisoning

- Department of Emergency Medicine, Yidu Central Hospital of Weifang, Weifang, Shandong, 262500, China

More Information

Corresponding author: CUI Wenhua, E-mail: wenhuacui@163.com

Received Date: 13 May 2020

摘要

摘要: 目的:探讨百草枯中毒并发急性呼吸窘迫综合征(ARDS)患者血浆白蛋白(ALB)、血浆胶体渗透压(COP)、毛细血管渗漏指数(CLI)变化的特点以及对ARDS的诊断及预后预测价值。方法:回顾性分析收治的167例百草枯中毒患者,根据是否发生ARDS分为未发生ARDS组(82例)和发生ARDS组(85例),收集入ICU时(T1)及诊断ARDS时(T2)的血浆ALB、COP和CLI,比较T1和T2时间点各指标的变化,并采用受试者工作曲线(ROC)进行百草枯中毒合并ARDS诊断及预后效能评价。结果:百草枯合并ARDS组与非ARDS组T1时间点比较,T2时间点与T1时间点比较以及ARDS组中死亡组与存活组比较,ALB和COP均明显降低,CLI明显升高。ROC分析表明,T1时间点单一指标诊断ARDS的最大曲线下面积(AUC)为0.748(95%CI:0.674~0.822)(COP),联合诊断最大AUC为0.764(95%CI:0.694~0.835)(COP+CLI);T2时间点单一指标预测死亡的最大AUC为0.712(95%CI:0.604~0.820)(COP),联合预测最大AUC为0.725(95%CI:0.618~0.833)(ALB+COP)。结论:3种指标与百草枯中毒患者ARDS的发生及预后密切相关,特别是COP水平变化是诊断及评估预后不良的较好指标。
- 百草枯 /
- 中毒 /
- 急性呼吸窘迫综合征 /
- 胶体渗透压 /
- 毛细血管渗漏指数
Abstract: Objective: To investigate the changes of serum ALB, COP and CLI in acute respiratory distress syndrome(ARDS) secondary to paraquat poisoning, and to evaluate their clinical value in diagnosis and mortality predication of ARDS. Method: One hundred sixty-seven patients with PQ poisoning were devided into ARDS group(85 cases) and non-ARDS group(82 cases). ALB, COP and CLI at admission to ICU(T1) and the time-point when diagnosed for ARDS(T2) were collected. Receiver operating characteristic curve(ROC) was used to evaluate the performance of these indexes for the diagnosis and mortality prediction of acute paraquat-poisoned patients with ARDS. Result: The levels of ALB and COP were depressed, and CLI were elevated in ARDS patients compared with non-ARDS ones at T1 time-point. These three indexes had the same trend in T2 time-point compared with T1 time-point,and those of the dead patients were compared with those of survivors in ARDS group. ROC suggested that the best predictive AUCs of the early diagnosis in acute paraquat-poisoned patients with ARDS for single index and combination at T1 time-point were 0.748(95%CI: 0.674-0.822)(COP) and 0.764(95%CI: 0.694-0.835)(COP+CLI), respectively. Meanwhile the best predictive AUCs of 21-day mortality for single index and combination at T2 time-point were 0.712(95%CI: 0.604-0.820)(COP) and 0.725(95%CI: 0.618-0.833)(ALB+COP), respectively.Conclusion: ALB, COP and CLI are associated with the occurrence, development and poor prognosis in acute paraquat-poisoned patients with ARDS. It is possible that COP act as a significant diagnostic indicator for ARDS secondary to paraquat poisoning and as a predictive marker for poor prognosis of acute paraquat poisoning and as predictive markers for poor prognosis of acute paxaquat-poisoned patients with ARDS.
- paraquat /
- poisoning /
- acute respiratory distress syndrome /
- colloid osmotic pressure /
- capillary leakage index

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