摘要
目的:探讨急性百草枯中毒(APP)患者的血清淀粉酶(AMY)浓度与预后的关系。方法:回顾性分析我院急诊科2010-09-2016-09收治APP患者入院时的一般资料、血清AMY浓度和血浆百草枯(PQ)浓度,随访患者60d生存情况。计算PQ中毒严重指数(SIPP),并据其将患者分为3组[SIPP<10h·mg·L^(-1),10(h·mg·L^(-1))≤SIPP≤50(h·mg·L^(-1)),SIPP>50h·mg·L^(-1)],比较各组间血清AMY浓度,并分析血清AMY浓度与SIPP的相关性及对预后的评估价值。结果:死亡患者就诊时的血清AMY浓度显著高于存活患者[270.5(111,544.5)mmol/L vs.92(64.75,140)mmol/L,P<0.05]。AMY和SIPP预测死亡的ROC曲线下面积分别为0.802和0.839(P<0.05)。随着SIPP浓度升高,不同SIPP组间病死率差异有统计学意义(P<0.05),SIPP等级越高组,病死率越高(P<0.05),AMY浓度也越高(P<0.05)。AMY与SIPP呈正相关(r=0.133,P=0.04)。当截断值为183.5 mmol/L时,AMY评估预后的灵敏度、特异度和准确度分别为64.70%、87.50%和76.1%。当截断值为13.47h·mg·L^(-1)时,SIPP评估预后的灵敏度、特异度和准确度分别为80.10%、81.70%和80.9%。结论:血清AMY浓度可在一定程度上评估APP患者预后,在无条件检测PQ浓度的情况下,可结合其他指标进行综合判断。
Objective：To discuss the correlation between serum amylase （AMY） and prognosis of acute paraquat poisoning （APP） patients. Method： We reviewed the general data, Serum AMY concentrations and plasma paraquat concentrations of APP patients who were treated in emergency department,West China Hospital from september 2010 to september 2016. A 60-day follow-up was obtained from telephone contacts with patients. Calculated the Severity Index of Paraqaut Poisoning （SIPP） ,then divided the patients into three groups on the basis of SIPP [10 h·mg·L^-1〈SIPP,10（h·mg·L^-1）≤SIPP≤50（h·mg·L^-1） and SIPP〉50 h·mg·L^-1],compared the Serum AMY concentrations between each group. And analyzed the correlation between Serum AMY con- centrations and SIPP and evaluation value for the prognosis. Result：The serum AMY concentrations of death group was higher than the survival group on arrival [270.5（111,544. 5） mmol/L vs. 92（64.75,140） mmol/L,P〈0. 05]. The area under the Receiver Operating Characteristic （ROC） curve of Serum AMY concentrations and SIPP were 0. 802 and 0. 839,respectively （P〈0.05）. The mortality between different SIPP level group had significant differences （P〈0.05）. The higher SIPP level group had the higher Serum AMY concentrations （P%0.05）. Serum AMY concentrations was correlated positively with SIPP （r=0.133,P=0.04）. When the cut-off value was 183.5 mmol/L, the sensitivity, specificity and accuracy of Serum AMY concentrations were 64.70%, 87.50% and 76.1 respectively. And when the cut-off value was 13.47 h·mg·L^-1 , the sensitivity, specificity and accuracy of SIPP were 80.10%,81.70% and 80.9%, respectively. Conclusion： Serum AMY concentrations have clinical value for early evaluation of APP patients. When plasma paraquat concentrations can＇t be detected, AMY can be combined with other indicators for comprehensive judgment.
作者
曾茂妮
蒋臻
曹钰
李佳
许树云
姚蓉
姚鹏
彭丽媛
郝迪
ZENG Maoni IANG Zhen CAO Yu LI Jia XU Shuyun YAO Rong YAO Peng PENG Liyuan HAO Di(Emergency Department of West China Hosptial, Sichuan University, Chengdu 610041, China . Department of Respiratory, West China Hosptial, Sichuan University)
出处
《临床急诊杂志》
CAS
2017年第3期175-178,共4页
Journal of Clinical Emergency
基金
国家自然科学基金(No:30900493)
四川省应用基础研究计划项目(No:2013JY0011)
关键词
百草枯中毒
百草枯中毒严重指数
淀粉酶
预后
paraquat poisoning
severity index of paraqaut poisoning
amylase
prognosis
