CAJ | 학술논문

【目的】探讨和肽素、急性生理学及慢性健康状况评估Ⅱ（APACHEⅡ）在评估急性百草枯中毒（acute pa-raquat poisoning ，APP）预后的临床价值。【方法】选择126例APP患者，以住院期间临床死亡作为观察终点，分为存活组58例和死亡组68例。所有入选者在入院后2 h、24 h、7 d内抽取静脉血3 mL ，检测和肽素水平，同时连续记录APACHEⅡ评分的数据。【结果】死亡组服毒剂量显著大于存活组，而抢救时间、首次灌流时间和灌流次数之间无显著性差异（ P＞0．05）。入院后2 h和肽素水平，死亡组显著高于存活组（ P＜0．05）。而APACHEⅡ评分两组间无显著差异（ P＞0．05）。入院后24 h存活组和肽素降至正常，死亡组水平仍显著高于存活组（ P＜0．05），APACHEⅡ评分两组无差异（ P＞0．05）。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，两组差异有明显统计学意义（ P ＜0．05）。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Copeptin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】탐토화태소、급성생이학급만성건강상황평고Ⅱ（APACHEⅡ）재평고급성백초고중독（acute pa-raquat poisoning ，APP）예후적림상개치。【방법】선택126례APP환자，이주원기간림상사망작위관찰종점，분위존활조58례화사망조68례。소유입선자재입원후2 h、24 h、7 d내추취정맥혈3 mL ，검측화태소수평，동시련속기록APACHEⅡ평분적수거。【결과】사망조복독제량현저대우존활조，이창구시간、수차관류시간화관류차수지간무현저성차이（ P＞0．05）。입원후2 h화태소수평，사망조현저고우존활조（ P＜0．05）。이APACHEⅡ평분량조간무현저차이（ P＞0．05）。입원후24 h존활조화태소강지정상，사망조수평잉현저고우존활조（ P＜0．05），APACHEⅡ평분량조무차이（ P＞0．05）。입원후7 d사망조화태소수평지속불강，이APACHEⅡ평분수평명현승고，량조차이유명현통계학의의（ P ＜0．05）。APP환자구복농약제량여화태소、APACHEⅡ평분정정상관。【결론】련속검측Copeptin급APACHEⅡ평분대APP환자예후적평고급합리분배의료자원유중요림상의의。
To explore clinical value of Copeptin ,acute physiology and chronic health evaluation II (APACHE II) in the evaluation of the prognosis of acute paraquat poisoning (APP) .[Methods]Totally 126 pa-tients with APP were selected .When clinical death during hospital stay was taken as the endpoint ,all patients were divided into survival group( n =58) and death group( n=68) .Venous blood 3ml of all patients was drawn at 2h ,24h and 7d after admission .The level of Copeptin was detected .APACHE Ⅱ score was also continuously recorded .[Results] The poisoning dose in death group was significantly greater than that in survival group ,while there was no significant difference in rescue time ,first time of hemoperfusion and perfusion frequency ( P>0 .05) . The level of Copeptin in death group at 2h after admission was significantly higher than that in survival group ( P<0 .05) ,while there was no significant difference in APACHE Ⅱ score between two groups ( P >0 .05) .The level of Copeptin in survival group at 24h after admission was decreased to the normal ,but that in death group was still significantly higher than that in survival group ( P < 0 .05) ,and there was no significant difference in A-PACHE Ⅱ score between two groups( P>0 .05) .The level of Copeptin in death group at 7d after admission was continuously decreased ,but APACHE Ⅱ score was increased obviously ,and there was significant difference be-tween two groups( P <0 .05) .Oral dose of pesticides in patients with APP was positively correlated with Copep-tin and APACHE Ⅱ score .[Conclusion]Continuous measurement of Copeptin and APACHEⅡ score has impor-tant clinical significant in the evaluation of the prognosis of patients with APP and reasonable distribution of medi-cal resources .