中华急诊医学杂志2024,Vol.33Issue(1) :78-83.DOI:10.3760/cma.j.issn.1671-0282.2024.01.013

急性敌草快中毒患者预后相关因素分析

Analysis of prognostic factors in patients with acute diquat poisoning

谢梓萌 田质光 赵宁军 燕宪亮
中华急诊医学杂志2024,Vol.33Issue(1) :78-83.DOI:10.3760/cma.j.issn.1671-0282.2024.01.013

急性敌草快中毒患者预后相关因素分析

Analysis of prognostic factors in patients with acute diquat poisoning

谢梓萌 1田质光 2赵宁军 3燕宪亮4
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作者信息

  • 1. 徐州医科大学附属医院急诊医学科,徐州 221002
  • 2. 徐州市职业病防治医院中毒职业病科,徐州 221002
  • 3. 徐州医科大学附属医院急诊医学科,徐州 221002;徐州医科大学附属医院徐州市急诊医学重点实验室,徐州 221002
  • 4. 徐州医科大学附属医院急诊医学科,徐州 221002;徐州医科大学附属医院徐州市急诊医学重点实验室,徐州 221002;徐州市睢宁县人民医院急诊医学科,徐州 221200
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摘要

目的 探讨影响急性敌草快中毒(acute diquat poisoning,ADQP)患者近期预后的因素.方法 回顾性选取徐州医科大学附属医院、徐州市职业病防治医院2015年8月至2022年7月收治的ADQP患者为研究对象,按照中毒后30 d生存情况分为生存组和死亡组,比较两组患者的一般资料和来院后首次实验室检查结果,通过Logistic回归分析确认影响预后的独立危险因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线,评估指标对ADQP患者预后的价值.结果 本研究共纳入79例ADQP患者,其中存活组40例,死亡组39例.存活组和死亡组的年龄、中毒剂量、白细胞计数、谷氨酸转氨酶、谷草转氨酶、血肌酐、血尿素、中性粒/淋巴细胞比值、单核细胞/淋巴细胞比值、全身免疫炎症指数(systemic immune inflammation index,SII)比较,差异均有统计学意义(均P<0.05).多因素Logistic回归分析结果显示,中毒剂量(OR=1.018,95%CI:1.001~1.035,P=0.033)、血肌酐(OR=1.049,95%CI:1.005~1.095,P=0.028)、SII(OR=1.001,95%CI:1.000~1.002,P=0.029)是影响ADQP患者预后的独立危险因素.ROC曲线分析显示中毒剂量、血肌酐、SII三者联合的曲线下面积为0.968,敏感度为0.949,特异度为0.900,均较优于单独指标预测.结论 敌草快中毒剂量、血肌酐、SII是影响ADQP患者预后的独立危险因素,三者联合检测有较高的敏感度和特异度,可作为判断ADQP患者预后的可靠指标.

Abstract

Objective To investigate the factors influencing the short-term prognosis of patients with acute diquat poisoning(ADQP).Methods Patients with ADQP admitted to the Affiliated Hospital of Xuzhou Medical University and Xuzhou Occupational Disease Prevention Hospital from August 2015 to July 2022 were retrospectively selected.Patients were divided into survival group and death group according to 30-day survival status after poisoning.The general data and the results of the first laboratory examination after admission were compared between the two groups.Logistic regression analysis was used to analyze the independent risk factors associated with prognosis.And the receiver operating characteristic(ROC)curve was drawn to evaluate the prognostic value of risk factors in patients with ADQP.Results A total of 79 ADQP patients were included in this study,including 40 patients in the survival group and 39 patients in the death group.There were statistically significant differences in the age,poisoning dose,white blood cell,alanine aminotransferase,aspartate aminotransferase,serum creatinine,blood urea,neutrophil to lymphocyte ratio,monocyte to lymphocyte ratio,and systemic immune inflammation index(SII)between survival and death groups(all P<0.05).Multivariate logistic regression analysis showed that the poisoning dose(OR=1.018,95%CI:1.001-1.035,P=0.033),serum creatinine(OR=1.049,95%CI:1.005-1.095,P=0.028),and SII(OR=1.001,95%CI:1.000-1.002,P=0.029)were independent risk factors for the prognosis of patients with diquat poisoning.The areas under the curves of the combined detection of poisoning dose,serum creatinine and SII was 0.968,the sensitivity was 0.949,and the specificity was 0.900,which were higher than those of the single index.Conclusions The poisoning dose,serum creatinine and SII are independent prognostic predictors of patients with ADQP.The combination of three independent factors has higher sensitivity and specificity in evaluating the prognosis of ADQP,which could be used as a reliable indicator to predict the prognosis of patients with ADQP.

关键词

急性敌草快中毒/预后/危险因素/全身免疫炎症指数/肌酐

Key words

Acute diquat poisoning/Prognosis/Risk factors/Systemic immune inflammation index/Serum creatinine

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基金项目

徐州市国家临床重点专科培育项目(2018ZK004)

江苏省卫生健康委"六个一"工程科研项目(LGY2019085)

徐医附院优秀中青年人才项目资助(2019128009)

国家重点研发计划(2020YFC1512704)

出版年

2024
中华急诊医学杂志
中华医学会

中华急诊医学杂志

CSTPCDCSCD北大核心
影响因子:1.556
ISSN:1671-0282
参考文献量8
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