摘 要: 目的 探究急性有机磷农药中毒(AOPP)预后影响因素及QTc间期值的预测价值。方法 选取2019年1月至2020年4月本院收治的92例AOPP患者,根据患者28 d后生存情况分为死亡组(28例)、生存组(64例)。分析影响AOPP患者预后的相关因素,并以ROC曲线评估QTc间期值对AOPP患者预后的预测价值。结果 二元Logistics回归分析显示,服毒剂量、服毒至治疗时间间隔、QTc间期值、APACHE II评分、入院6 h血乳酸(Lac)水平、胆碱酯酶(ChE)活力、入院初始血pH值、入院初始血糖(Glu)、病情分级均为AOPP患者预后的相关影响因素(P<0.05)。ROC曲线分析显示,QTc间期值对AOPP患者预测死亡的AUC为0.928,具有较高准确性;以ROC曲线靠左上方约登指数的最大切点作为最佳临界值预测QTc间期值的敏感度、特异度分别为89.3%、85.9%,具有较高预测价值。QTc间期值延长者低血压、急性肾衰竭、呼吸衰竭、死亡的发生率明显高于QTc间期值正常者,差异有统计学意义(P<0.05)。结论 服毒剂量、服毒至治疗时间间隔、QTc间期值、APACHE II评分、入院6 h Lac水平、 ChE活力、入院初始血液pH值、入院初始Glu、病情分级是AOPP患者预后的影响因素;QTc间期值对AOPP患者预后具有较高的预测评估价值。 |
关键词: 急性有机磷农药中毒(AOPP) 预后 影响因素 QTc间期值 预测价值 |
中图分类号: R595.4
文献标识码: A
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基金项目: |
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Analysis on prognostic factors of acute organophosphorus pesticide poisoning and predictive value of QTc interval |
ZHOU Yu,TANG Xin-hua,FU Yuan-zhong,CHEN Ying
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Emergency Department of West China Guang'an Hospital of Sichuan University,Guang'an 638000,China
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Abstract: Objective To explore the prognostic factors of acute organophosphorus pesticide poisoning(AOPP) and the predictive value of QTc interval. Methods A total of 92 patients with AOPP admitted to our hospital from January 2019 to April 2020 were selected,and divided into the death group(28 patients)and the survival group(64 patients)according to their clinical outcome at the 28th day after poisoning. Then the prognosis factors of AOPP were analyzed,and the ROC curve was used as well to evaluate the predictive value of QTc interval for AOPP patients. Results The results showed that according to the binary Logistics regression analysis,the exposed dose,time interval from poisoning to gastric lavage,QTc interval,APACHE II score,blood lacate level 6 hours after admission,cholinesterase vitality,initial blood pH,initial blood glucose and severity grading were related regarded as the prognostic factors of AOPP(P<0.05). The ROC curve analysis showed that the AUC predicted by QTc interval for AOPP patients was 0.928,which had high accuracy;based on the maximum tangent point of Jordan index at the upper left of ROC curve,the sensitivity and specificity of QTc were 89.3% and 85.9%,respectively,with higher predictive value. The incidences of hypotension,acute renal failure,respiratory failure and death in QTc prolonged group were all significantly higher than that of QTc normal groups,differences were statistically significant(P<0.05). Conclusion The results suggested that exposed dose,time interval from poisoning to gastric lavage,QTc interval,APACHE II score,blood lacate level 6 hours after admission,cholinesterase vitality,initial blood pH,initial blood glucose and severity grading were the influencing factors for the prognosis of AOPP;while the QTc interval value showed high value in prediction evaluation for the patients with AOPP. |
Keywords: acute organophosphorus pesticide poisoning(AOPP) prognosis influencing factors QTc interval value predictive value |