CAJ | 학술논문

目的：探讨在急性百草枯中毒（acute paraquat poisoning，APP）患者中和肽素（copeptin）、APACHEⅡ评分在预后评估中的应用价值。方法：选择126例APP患者，以住院期间临床死亡作为观察终点，分存活组58例和死亡组68例。在入院后2 h、24 h、7 d 内抽取静脉血3 mL，检测和肽素水平，同时记录 APACHEⅡ评分。结果：死亡组服毒剂量明显高于存活组，而抢救时间、首次灌流时间和灌流次数之间无差异。入院后2 h和肽素水平升高，死亡组与存活组比较有显著差异，而APACHEⅡ评分无差异。入院后24 h存活组和肽素降至正常，死亡组水平较高，APACHEⅡ评分两组无差异。入院后7 d死亡组和肽素水平持续不降，而APACHEⅡ评分水平明显升高，两组差异有统计学意义。APP患者口服农药剂量与和肽素、APACHEⅡ评分呈正相关。结论：连续检测和肽素及APACHEⅡ评分对APP患者预后的评估及合理分配医疗资源有重要临床意义。
목적：탐토재급성백초고중독（acute paraquat poisoning，APP）환자중화태소（copeptin）、APACHEⅡ평분재예후평고중적응용개치。방법：선택126례APP환자，이주원기간림상사망작위관찰종점，분존활조58례화사망조68례。재입원후2 h、24 h、7 d 내추취정맥혈3 mL，검측화태소수평，동시기록 APACHEⅡ평분。결과：사망조복독제량명현고우존활조，이창구시간、수차관류시간화관류차수지간무차이。입원후2 h화태소수평승고，사망조여존활조비교유현저차이，이APACHEⅡ평분무차이。입원후24 h존활조화태소강지정상，사망조수평교고，APACHEⅡ평분량조무차이。입원후7 d사망조화태소수평지속불강，이APACHEⅡ평분수평명현승고，량조차이유통계학의의。APP환자구복농약제량여화태소、APACHEⅡ평분정정상관。결론：련속검측화태소급APACHEⅡ평분대APP환자예후적평고급합리분배의료자원유중요림상의의。
Objective To study the value of copeptin and APACHE Ⅱ used for assessing acute paraquat poisoning (APP). Methods One hundred and twenty six APP patients were divided into survival group (n = 58) and death group (n = 68), with clinical death as the endpoint of observation. 3 mL blood was obtained from each subject at 2 h , 24 h and 7 d after admission for detecting the levels of copeptin , and APACHE Ⅱ scores were recorded at the same time. Results There was significant difference in dosages of paraquat taken in the death group and the survival group , but the differences were significant in the rescue time , the first time for hemoperfusion and the times for hemoperfusion. 2 h after admission , the death group and survival group had significant difference in elevated copeptin but no significant difference in scores by APACHE Ⅱ. 24 h after admission copeptin decreased to normal level in the survival group but maintained at a higher level in the death group, while the scores by APACHE Ⅱ had insignificant difference between two groups. 7 d after admission, copeptin kept at a higher level and the scores by APACHE Ⅱwere significantly increased in the death group , with significant differences compared to the survival group. The oral doses of pesticides the patients took were positively correlated with copeptin level and scores by APACHE Ⅱ. Conclusion Repeated detection of copeptin and APACHE Ⅱ score are of clinical importance for the assessment of prognosis of APP patients and reasonable distribution of medical resources.