目的 探讨中毒早期血浆毒物浓度测定在急性百草枯中毒(APP)患者肝肾功能损伤程度及预后评估中的作用. 方法 收集军事医学科学院附属医院2006年6月至2012年6月收治的APP患者的病历资料进行回顾性分析.病例入选标准为口服中毒、未行输液及血液灌流治疗、中毒至入院时间≤6 h.根据入院时测得的血浆百草枯浓度将患者分为低浓度组(＜0.5 mg/L)、中浓度组(0.5～2.0 mg./L)和高浓度组(＞2.0 mg/L).比较3组患者住院期间丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素、血尿素、血肌酐水平的最高检测值和病死率. 结果 共收集到符合标准的APP患者87例,男性48例,女性39例,年龄9～76(30±14)岁.低浓度组31例,中浓度组27例,高浓度组29例,3组患者的性别、年龄分布和中毒至入院时间差异无统计学意义(P＞0.05).低、中、高浓度组患者的ALT最高检测值的中位数(四分位数间距)分别为39(18,87)、126(92,249)和345(108,666) U/L,AST分别为29(25,37)、120(57,222)和233(106,361) U/L,总胆红素分别为24(18,33)、31(22,52)和65(39,86) μmol/L,血肌酐分别为77(59,136)、243(134,421)和295(248,489) μmol/L,血尿素分别为8(5,11)、15 (13,21)和24(19,27) mmol/L,病死率分别为3.2％(1/31)、44.4％(12/27)和86.2％(25/29).3组之间两两比较,上述各项指标的差异均有统计学意义(P ＜0.05,P＜0.01). 结论 中毒早期血浆毒物浓度可以作为评估APP患者肝肾功能损伤程度和预后的指标.
目的 探討中毒早期血漿毒物濃度測定在急性百草枯中毒(APP)患者肝腎功能損傷程度及預後評估中的作用. 方法 收集軍事醫學科學院附屬醫院2006年6月至2012年6月收治的APP患者的病歷資料進行迴顧性分析.病例入選標準為口服中毒、未行輸液及血液灌流治療、中毒至入院時間≤6 h.根據入院時測得的血漿百草枯濃度將患者分為低濃度組(＜0.5 mg/L)、中濃度組(0.5～2.0 mg./L)和高濃度組(＞2.0 mg/L).比較3組患者住院期間丙氨痠轉氨酶(ALT)、天鼕氨痠轉氨酶(AST)、總膽紅素、血尿素、血肌酐水平的最高檢測值和病死率. 結果 共收集到符閤標準的APP患者87例,男性48例,女性39例,年齡9～76(30±14)歲.低濃度組31例,中濃度組27例,高濃度組29例,3組患者的性彆、年齡分佈和中毒至入院時間差異無統計學意義(P＞0.05).低、中、高濃度組患者的ALT最高檢測值的中位數(四分位數間距)分彆為39(18,87)、126(92,249)和345(108,666) U/L,AST分彆為29(25,37)、120(57,222)和233(106,361) U/L,總膽紅素分彆為24(18,33)、31(22,52)和65(39,86) μmol/L,血肌酐分彆為77(59,136)、243(134,421)和295(248,489) μmol/L,血尿素分彆為8(5,11)、15 (13,21)和24(19,27) mmol/L,病死率分彆為3.2％(1/31)、44.4％(12/27)和86.2％(25/29).3組之間兩兩比較,上述各項指標的差異均有統計學意義(P ＜0.05,P＜0.01). 結論 中毒早期血漿毒物濃度可以作為評估APP患者肝腎功能損傷程度和預後的指標.
목적 탐토중독조기혈장독물농도측정재급성백초고중독(APP)환자간신공능손상정도급예후평고중적작용. 방법 수집군사의학과학원부속의원2006년6월지2012년6월수치적APP환자적병력자료진행회고성분석.병례입선표준위구복중독、미행수액급혈액관류치료、중독지입원시간≤6 h.근거입원시측득적혈장백초고농도장환자분위저농도조(＜0.5 mg/L)、중농도조(0.5～2.0 mg./L)화고농도조(＞2.0 mg/L).비교3조환자주원기간병안산전안매(ALT)、천동안산전안매(AST)、총담홍소、혈뇨소、혈기항수평적최고검측치화병사솔. 결과 공수집도부합표준적APP환자87례,남성48례,녀성39례,년령9～76(30±14)세.저농도조31례,중농도조27례,고농도조29례,3조환자적성별、년령분포화중독지입원시간차이무통계학의의(P＞0.05).저、중、고농도조환자적ALT최고검측치적중위수(사분위수간거)분별위39(18,87)、126(92,249)화345(108,666) U/L,AST분별위29(25,37)、120(57,222)화233(106,361) U/L,총담홍소분별위24(18,33)、31(22,52)화65(39,86) μmol/L,혈기항분별위77(59,136)、243(134,421)화295(248,489) μmol/L,혈뇨소분별위8(5,11)、15 (13,21)화24(19,27) mmol/L,병사솔분별위3.2％(1/31)、44.4％(12/27)화86.2％(25/29).3조지간량량비교,상술각항지표적차이균유통계학의의(P ＜0.05,P＜0.01). 결론 중독조기혈장독물농도가이작위평고APP환자간신공능손상정도화예후적지표.
Objective To explore the significance of early measurement of plasma-paraquat concentrations in assessing the severity of liver and kidney injury and predicting the outcome in patients with acute paraquat poisoning (APP).Methods The case reports of patients with APP in Department of Gastroenterology,Affiliated Hospital of Academy of Military Medical Science from June 2006 to June 2012 were collected and retrospectively analyzed.The inclusion criteria were as follows:the patients were orally poisoned,without undergoing infusion and hemoperfusion treatment,the time from poisoning to admission ≤6 h.According to the plasma-paraquat concentrations measured on admission,the patients were divided into the low-concentration group (＜ 0.5 mg/L),moderate-concentration group (0.5-2.0 mg/L),and high-concentration group (＞ 2.0 mg/L).The highest values of alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin,blood urea,and serum creatinine levels detected during hospitalization in the 3 groups were compared.The mortalities in the 3 groups were calculated and compared.Results Data of a total of 87 patients were collected according to the inclusion criteria.Of them,48 patients were male and 39 were female with age of 9-76 (30 ± 14) years.There were 31,27,and 29 patients in the low-,moderate-,and high-concentration groups,respectively.The differences in gender,age distribution,and the time from poisoning to admission among the 3 groups were not statistically significant (P ＞ 0.05).The median (Q1,Q3) of the highest values of AST,ALT,total bilirubin,blood urea,and serum creatinine levels in the 3 groups were 39 (18,87),126 (92,249),and 345 (108,666) U/L; 29(25,37),120(57,222),and 233(106,361) U/L; 24(18,33),31(22,52),and 65(39,86) μmol/L; 77(59,136),243(134,421),and 295(248,489) μmol/L; 8(5,11),15(13,21),and 24(19,27) mmol/L; respectively.The mortalities in the 3 groups were 3.2％ (1/31),44.4％ (12/27),and 86.2％ (25/29),respectively.Pairwise comparisons among the 3 groups were performed and the differencesin all items mentioned above were significant statistically (P ＜ 0.05 or P ＜ 0.01).Conclusion Plasma-paraquat concentrations measured in the early stage of paraquat poisoning could be used to assess the severity of liver and kidney injury and predict the outcome in patients with APP.
