重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2014年
30期
4028-4029,4033
,共3页
丁酰胆碱酯酶%急救%中毒%危险性评估%预后
丁酰膽堿酯酶%急救%中毒%危險性評估%預後
정선담감지매%급구%중독%위험성평고%예후
butyrylcholinesterase%first aid%poisoning%risk assessment%prognosis
目的：探讨丁酰胆碱酯酶（BuChE）活性评估院前急性有机磷农药中毒（AOPP）患者病情及预后的应用效果。方法选择院前急救AOPP患者110例，所有患者在院前采集静脉血测定BuChE活性，并以入院治疗60 d为观察界限，分析BuChE特征曲线及预测指标。结果110例患者中死亡24例，存活96例，其中死亡组院前BuChE活性为（36．7±34．2）％，存活组院前BuChE活性（67．2±15．4）％，两组差异有统计学意义（P＜0．05）。ROC曲线判断 AOPP最佳截断点为BuChE活性小于或等于30％正常值。27例BuChE活性小于或等于30％正常值者病死率为74．07％（20/27），93例大于30％正常值者病死率为4．30％（8/93）。两者病死率比较有差异有统计学意义（P＜0．01）。当院前AOPP患者危重度的最佳截断点为BuChE活性小于或等于30％正常值，对其死亡预测的特异度为0．954，敏感度0．761，阳性预测值0．825，准确度0．912，约登指数0．716。结论 BuChE活性对AOPP病情具有快速、有效的预测价值，值得临床推广应用。
目的：探討丁酰膽堿酯酶（BuChE）活性評估院前急性有機燐農藥中毒（AOPP）患者病情及預後的應用效果。方法選擇院前急救AOPP患者110例，所有患者在院前採集靜脈血測定BuChE活性，併以入院治療60 d為觀察界限，分析BuChE特徵麯線及預測指標。結果110例患者中死亡24例，存活96例，其中死亡組院前BuChE活性為（36．7±34．2）％，存活組院前BuChE活性（67．2±15．4）％，兩組差異有統計學意義（P＜0．05）。ROC麯線判斷 AOPP最佳截斷點為BuChE活性小于或等于30％正常值。27例BuChE活性小于或等于30％正常值者病死率為74．07％（20/27），93例大于30％正常值者病死率為4．30％（8/93）。兩者病死率比較有差異有統計學意義（P＜0．01）。噹院前AOPP患者危重度的最佳截斷點為BuChE活性小于或等于30％正常值，對其死亡預測的特異度為0．954，敏感度0．761，暘性預測值0．825，準確度0．912，約登指數0．716。結論 BuChE活性對AOPP病情具有快速、有效的預測價值，值得臨床推廣應用。
목적：탐토정선담감지매（BuChE）활성평고원전급성유궤린농약중독（AOPP）환자병정급예후적응용효과。방법선택원전급구AOPP환자110례，소유환자재원전채집정맥혈측정BuChE활성，병이입원치료60 d위관찰계한，분석BuChE특정곡선급예측지표。결과110례환자중사망24례，존활96례，기중사망조원전BuChE활성위（36．7±34．2）％，존활조원전BuChE활성（67．2±15．4）％，량조차이유통계학의의（P＜0．05）。ROC곡선판단 AOPP최가절단점위BuChE활성소우혹등우30％정상치。27례BuChE활성소우혹등우30％정상치자병사솔위74．07％（20/27），93례대우30％정상치자병사솔위4．30％（8/93）。량자병사솔비교유차이유통계학의의（P＜0．01）。당원전AOPP환자위중도적최가절단점위BuChE활성소우혹등우30％정상치，대기사망예측적특이도위0．954，민감도0．761，양성예측치0．825，준학도0．912，약등지수0．716。결론 BuChE활성대AOPP병정구유쾌속、유효적예측개치，치득림상추엄응용。
Objective To investigate the evaluation for condition and prognosis of butyrylcholinesterase(BuChE)evaluation for acute organophosphorus pesticide poisoning (AOPP) .Methods 110 cases of AOPP patients were collected ,venous blood of all the patients in pre-hospital was sampled for determination of BuChE activity ,and treatment lasted for 60 d ,then BuChE characteristic curves and forecast indexs were analyzed .Results 24 cases died and 96 cases survived ,pre-hospital BuChE activity of the death group was (36 .7 ± 34 .2)% ,and the survival group was (67 .2 ± 15 .4)% ,there was significant difference between the two groups (P<0 .05) .That BuChE activity≤30% of normal value in ROC curve was the optimal cut-off point to determine the AOPP poi-soning .Among 27 cases of patients ,who BuChE activity ≤30% of normal value ,the death rate was 74 .07% (20/27) ,among 93 cases of patients ,who BuChE activity>30% of normal value ,the death rate was 4 .30% (8/93) ,there was significant difference between the two groups(P<0 .01) .When the optimal cut-off point of BuChE activity was≤30% of normal value in pre-hospital patients with critical AOPP ,the specific degree of its death prediction was 0 .954 ,sensitivity was 0 .761 ,positive predictive value was 0 .825 ,accuracy was 0 .912 ,Youden index was 0 .716 .Conclusion BuChE activity is a rapid and effective predicted value for the AOPP ,it is worthy of clinical application .
