摘要
目的 探讨血清C反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)、肌酸激酶同工酶(CK-MB)水平及急性生理与慢性健康评分(APACHE Ⅱ)评估有机磷中毒病情程度和预后关系.方法 选取许昌市中心医院2019年1月至2022年12月收治的有机磷中毒患者82例作为研究对象,按病情严重程度将研究组患者分为轻度组(n=25)、中度组(n=31)、重度组(n=26).测定受试者血清CRP、ALT、CK-MB水平,记录患者入院后24 h内APACHEⅡ评分,采用Spearman相关性检验,分析血清CRP、ALT、CK-MB水平、APACHE Ⅱ评分与有机磷中毒的疾病严重程度的相关性.治疗后,根据预后情况,将82例研究对象分为存活组68例、死亡组14例.比较存活组、死亡组血清CRP、ALT、CK-MB水平及APACHE Ⅱ评分.结果 轻度组、中度组、重度组的血清CRP、ALT、CK-MB水平及APACHE Ⅱ评分随着中毒严重程度增加而上升(P＜0.05).血清CRP、ALT、CK-MB水平、APACHE Ⅱ评分与有机磷中毒的疾病严重程度呈正相关(r=0.671、0.716、0.739、0.684,P＜0.001).死亡组血清CRP、ALT、CK-MB水平、APACHE Ⅱ评分均高于存活组(P＜0.05).根据各项指标绘制的预测有机磷中毒患者预后不良的ROC曲线显示,血清CRP、ALT、CK-MB水平、APACHE Ⅱ评分及联合检验的曲线下面积分别为0.764、0.725、0.778、0.691、0.876.结论 血清CRP、ALT、CK-MB水平、APACHE Ⅱ评分与有机磷中毒疾病的严重程度呈正相关,且在一定程度上反映中毒后的预后情况.
Abstract
Objective To evaluate the value of serum C reactive protein(CRP),alanine transaminase(ALT),creatine kinase isoenzyme MB(CK-MB)levels and Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ)score in assessing the disease severity and prognosis of organophosphorus poisoning.Methods Eighty-two patients with organophosphorus poisoning in Xuchang Central Hospital from January 2019 to December 2022 were enrolled,and the patients were classified into mild group(n=25),moderate group(n=31)and severe group(n=26)according to their disease severity.The serum CRP,ALT and CK-MB levels of the subjects,as well as APACHE Ⅱ scores were recorded within 24 h after admission.Then Spearman correlation test was performed to analyze the correlation of serum CRP,ALT,CK-MB levels,and APACHE Ⅱ score with disease severity in patients with organophosphorus poisoning.After treatment,82 subjects were divided into survival group(68 cases)and death group(14 cases)according to prognosis.The serum CRP,ALT,CK-MB levels,and APACHE Ⅱ score were compared between survival group and death group.Results The levels of serum CRP,ALT,CK-MB and APACHE Ⅱ score in mild,moderate and severe groups increased with the increase of poisoning severity(P＜0.05).The serum CRP,ALT,CK-MB levels,and APACHE Ⅱscores were positively correlated with disease severity of organophosphorus poisoning(r=0.671,0.716,0.739,0.684,P＜0.001).The serum CRP,ALT,CK-MB levels and APACHE Ⅱ scores were higher in death group than those in surviving group(P＜0.05).Receiver operating characteristic(ROC)curves revealed that the area under the curve for the separate and combined test of CRP,ALT,CK-MB,and APACHE Ⅱ in predicting the poor prognosis were 0.764,0.725,0.778,0.691 and 0.876,respectively.Conclusions Serum CRP,ALT,CK-MB levels and APACHE Ⅱ score are positively correlated with the severity of organophosphorus poisoning and can reflect the prognosis after poisoning in certain degree.
NETL
NSTL
万方数据