中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
14期
69-70,72
,共3页
李静%李勇%田建元%寿松涛%李腾
李靜%李勇%田建元%壽鬆濤%李騰
리정%리용%전건원%수송도%리등
百草枯中毒%急性肾损伤%血清胱抑素
百草枯中毒%急性腎損傷%血清胱抑素
백초고중독%급성신손상%혈청광억소
PQ poisoning%Acute kidney injury%Serum cystatin C
目的：探讨急性百草枯(Parqual，PQ)中毒的肾功能指标动态变化及其临床意义。方法：对中毒组(43例)和对照组(20例)进行血清胱抑素(CysC)、肌酐(CREA)、尿素氮(BUN)、β2-微球蛋白(β2-MG)及尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的测定，依据对照组和中毒存活组、死亡组的肾功能指标的变化结果进行统计学分析。结果：急性 PQ 中毒患者死亡组的急性肾功能异常显著高于存活组，在 CysC 和 NGAL 测量值的动态变化上显著高于存活组；CysC 以1.94μmol/L 为截断点时，预测急性 PQ 中毒患者死亡的敏感度66.7%，特异性95.6%；尿NGAL以58.64μg/L为截断点时，预测急性PQ中毒患者死亡的敏感度72.2%，特异性91.1%。结论：急性PQ中毒患者早期出现肾功能异常提示预后不佳。动态监测CysC和尿NGAL变化可指导临床治疗。
目的：探討急性百草枯(Parqual，PQ)中毒的腎功能指標動態變化及其臨床意義。方法：對中毒組(43例)和對照組(20例)進行血清胱抑素(CysC)、肌酐(CREA)、尿素氮(BUN)、β2-微毬蛋白(β2-MG)及尿中性粒細胞明膠酶相關脂質運載蛋白(NGAL)的測定，依據對照組和中毒存活組、死亡組的腎功能指標的變化結果進行統計學分析。結果：急性 PQ 中毒患者死亡組的急性腎功能異常顯著高于存活組，在 CysC 和 NGAL 測量值的動態變化上顯著高于存活組；CysC 以1.94μmol/L 為截斷點時，預測急性 PQ 中毒患者死亡的敏感度66.7%，特異性95.6%；尿NGAL以58.64μg/L為截斷點時，預測急性PQ中毒患者死亡的敏感度72.2%，特異性91.1%。結論：急性PQ中毒患者早期齣現腎功能異常提示預後不佳。動態鑑測CysC和尿NGAL變化可指導臨床治療。
목적：탐토급성백초고(Parqual，PQ)중독적신공능지표동태변화급기림상의의。방법：대중독조(43례)화대조조(20례)진행혈청광억소(CysC)、기항(CREA)、뇨소담(BUN)、β2-미구단백(β2-MG)급뇨중성립세포명효매상관지질운재단백(NGAL)적측정，의거대조조화중독존활조、사망조적신공능지표적변화결과진행통계학분석。결과：급성 PQ 중독환자사망조적급성신공능이상현저고우존활조，재 CysC 화 NGAL 측량치적동태변화상현저고우존활조；CysC 이1.94μmol/L 위절단점시，예측급성 PQ 중독환자사망적민감도66.7%，특이성95.6%；뇨NGAL이58.64μg/L위절단점시，예측급성PQ중독환자사망적민감도72.2%，특이성91.1%。결론：급성PQ중독환자조기출현신공능이상제시예후불가。동태감측CysC화뇨NGAL변화가지도림상치료。
Objective:To explore the dynamic changes of the indexes of renal function and its clinical significance of acute paraquat poisoning.Methods:Serum cystatin C(CysC),creatinine(CREA),blood urea nitrogen(BUN),β2-microglobulin(β2-MG) and urinary neutrophil gelatinase associated lipocalin(NGAL)of poisoning group(43 cases)and control group(20 cases)were measured.We observed the changes in renal function indexes of the control group,the poisoning survival group, and poisoning death group,and took statistical analysis.Results:In patients with acute PQ poisoning,acute renal dysfunction of poisoning death group was significantly higher than the survival group.Dynamic changes of CysC and NGAL measurements were significantly higher than the survival group.When the CysC with 1.94umol/L was as the cut-off point,the sensitivity of prediction of death in patients with acute PQ poisoning was 66.7%,specificity was 95.6%.When the Urinary NGAL with 58.64μg/L was as the cut-off point,the sensitivity of prediction of death in patients with acute PQ poisoning was 72.2%,specificity was 91.1%.Conclusion:In patients with acute PQ poisoning,early renal function abnormalities predict poor prognosis.Dynamic monitoring of the changes of CysC and urinary NGAL can guide clinical treatment.
