中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
12期
9-12
,共4页
曾璟%李舜午%彭苏娜%高燕
曾璟%李舜午%彭囌娜%高燕
증경%리순오%팽소나%고연
有机磷化合物%中毒%利钠肽,脑%磷
有機燐化閤物%中毒%利鈉肽,腦%燐
유궤린화합물%중독%리납태,뇌%린
Organophosphorus compounds%Poisoning%Natriuretic peptide,brain%Phosphorus
目的 探讨重度急性有机磷农药中毒(AOPP)患者N末端脑钠肽前体(NT-proBNP)和血磷变化的临床意义.方法 选取78例重度AOPP患者,分为死亡组(54例)和存活组(24例).分别于入院时,入院1、2、4d后,转出ICU时或死亡前检测NT-proBNP和血磷.结果 两组入院时NT-proBNP和血磷比较差异无统计学意义(P＞0.05)；入院1、2、4d后,死亡组NT-pROBNP明显高于存活组[死亡组:( 1986.5±24.9)、(3568.2±56.9)、(7829.0±64.3) ng/L;存活组:(1068.4 ±20.2)、(986.6±16.4)、( 943.7±14.6) ng/L,P＜0.05或＜0.01],血磷明显低于存活组[死亡组:(1.22±0.13)、(0.81±0.10)、(0.58±0.07) mmol/L;存活组:(1.53±0.16)、(1.48±0.13)、( 1.46±0.14) mmol/L,P＜0.05或＜0.01]；且随着时间的延长,死亡组患者的Nt-proBNP逐渐升高(P＜0.05),血磷逐渐降低(P＜0.05)；存活组在转出ICU时NT-proBNP较入院时明显降低[(327.5±12.3) ng/L比(1023.3±18.8) ng/L,P＜0.05]；存活组各时间点血磷比较差异无统计学意义(P＞0.05)；死亡组死亡前NT-proBNP明显高于存活组转出ICU时[(31 486.5±120.7) ng/L比(327.5±12.3) ng/L,P＜0.01],血磷明显低于存活组转出ICU时[(0.24±0.03) mmol/L比(1.57±0.15) mmol/L,P＜0.01].结论 重度AOPP患者随着病情的进展,NT-proBNP逐渐升高,血磷逐渐降低,NT-proBNP和血磷是反映重度AOPP患者预后指标.
目的 探討重度急性有機燐農藥中毒(AOPP)患者N末耑腦鈉肽前體(NT-proBNP)和血燐變化的臨床意義.方法 選取78例重度AOPP患者,分為死亡組(54例)和存活組(24例).分彆于入院時,入院1、2、4d後,轉齣ICU時或死亡前檢測NT-proBNP和血燐.結果 兩組入院時NT-proBNP和血燐比較差異無統計學意義(P＞0.05)；入院1、2、4d後,死亡組NT-pROBNP明顯高于存活組[死亡組:( 1986.5±24.9)、(3568.2±56.9)、(7829.0±64.3) ng/L;存活組:(1068.4 ±20.2)、(986.6±16.4)、( 943.7±14.6) ng/L,P＜0.05或＜0.01],血燐明顯低于存活組[死亡組:(1.22±0.13)、(0.81±0.10)、(0.58±0.07) mmol/L;存活組:(1.53±0.16)、(1.48±0.13)、( 1.46±0.14) mmol/L,P＜0.05或＜0.01]；且隨著時間的延長,死亡組患者的Nt-proBNP逐漸升高(P＜0.05),血燐逐漸降低(P＜0.05)；存活組在轉齣ICU時NT-proBNP較入院時明顯降低[(327.5±12.3) ng/L比(1023.3±18.8) ng/L,P＜0.05]；存活組各時間點血燐比較差異無統計學意義(P＞0.05)；死亡組死亡前NT-proBNP明顯高于存活組轉齣ICU時[(31 486.5±120.7) ng/L比(327.5±12.3) ng/L,P＜0.01],血燐明顯低于存活組轉齣ICU時[(0.24±0.03) mmol/L比(1.57±0.15) mmol/L,P＜0.01].結論 重度AOPP患者隨著病情的進展,NT-proBNP逐漸升高,血燐逐漸降低,NT-proBNP和血燐是反映重度AOPP患者預後指標.
목적 탐토중도급성유궤린농약중독(AOPP)환자N말단뇌납태전체(NT-proBNP)화혈린변화적림상의의.방법 선취78례중도AOPP환자,분위사망조(54례)화존활조(24례).분별우입원시,입원1、2、4d후,전출ICU시혹사망전검측NT-proBNP화혈린.결과 량조입원시NT-proBNP화혈린비교차이무통계학의의(P＞0.05)；입원1、2、4d후,사망조NT-pROBNP명현고우존활조[사망조:( 1986.5±24.9)、(3568.2±56.9)、(7829.0±64.3) ng/L;존활조:(1068.4 ±20.2)、(986.6±16.4)、( 943.7±14.6) ng/L,P＜0.05혹＜0.01],혈린명현저우존활조[사망조:(1.22±0.13)、(0.81±0.10)、(0.58±0.07) mmol/L;존활조:(1.53±0.16)、(1.48±0.13)、( 1.46±0.14) mmol/L,P＜0.05혹＜0.01]；차수착시간적연장,사망조환자적Nt-proBNP축점승고(P＜0.05),혈린축점강저(P＜0.05)；존활조재전출ICU시NT-proBNP교입원시명현강저[(327.5±12.3) ng/L비(1023.3±18.8) ng/L,P＜0.05]；존활조각시간점혈린비교차이무통계학의의(P＞0.05)；사망조사망전NT-proBNP명현고우존활조전출ICU시[(31 486.5±120.7) ng/L비(327.5±12.3) ng/L,P＜0.01],혈린명현저우존활조전출ICU시[(0.24±0.03) mmol/L비(1.57±0.15) mmol/L,P＜0.01].결론 중도AOPP환자수착병정적진전,NT-proBNP축점승고,혈린축점강저,NT-proBNP화혈린시반영중도AOPP환자예후지표.
Objective To observe the change of blood phosphorus and N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with severe acute organophosphorus pesticide poisoning (AOPP)and explore their clinical significance.Methods Seventy-eight severe AOPP patients were selected and divided into dead group (54 cases) and survival group (24 cases).NT-proBNP and blood phosphorus were examined when the patients were just hospitalized,and after 1,2,4 d and when they were turn out from ICU or before the patients dead.Results Comparing with survival group,blood phosphorus and NT-proBNP of dead group had no significant difference when the patients were just hospitalized(P＞ 0.05 ).After 1,2 and 4d NT-proBNP of dead group [ ( 1986.5 ± 24.9),(3568.2 ± 56.9),(7829.0 ± 64.3 ) ng/L ]was higher than that of survival group [ ( 1068.4 ± 20.2),(986.6 ± 16.4),(943.7 ± 14.6) ng/L,P ＜ 0.05 or ＜ 0.01 ],while blood phosphorus was significant lower than that in survival group [ ( 1.22 ± 0.13 ),(0.81 ± 0.10),(0.58 ±0.07 ) mmol/L vs.( 1.53 ± 0.16),( 1.48 ± 0.13 ),( 1.46 ± 0.14 ) mmol/L,P ＜ 0.05 or ＜ 0.01 ].NT-proBNP of dead group increased and blood phosphorus reduced gradually by time extending (P ＜ 0.05).NT-proBNP was lower when patients were turn out from ICU than that when the patients were just hospitalized [ (327.5 ±12.3) ng/L vs. (1023.3 ± 18.8) ng/L,P ＜ 0.05].Blood phosphorus had no difference at all time points in survival group (P ＞ 0.05 ).NT-proBNP was higher [ ( 31 486.5 ± 120.7) ng/L vs.(327.5 ± 12.3) ng/L,P ＜0.01 ]and blood phosphorus was lower [ (0.24 ± 0.03 ) mmol/L vs.( 1.57 ± 0.15 ) mmol/L,P ＜ 0.01 ]before death in dead group compared with those at the time turning out from ICU in survival group.Conclusions The value of NT-proBNP increased and blood phosphorus reduced gradually with disease progression.NT-proBNP and blood phosphorus were important factors reflecting the prognosis of blood AOPP patients.
