摘要
目的探讨急性有机磷农药中毒(AOPP)患者外周血C反应蛋白(CRP)、白介素-18(IL-18)水平与早期肝损伤的相关性。方法选取2013年3月至2016年4月解放军武汉总医院收治的AOPP患者(AOPP组)128例,按中毒程度分为轻度组(n=36)、中度组(n=45)和重度组(n=47),选取同期解放军武汉总医院56例健康体检者作为对照组。对比各组对象在入院时、入院第1、3及7天时外周血CRP、IL-18水平及肝功能五项指标,采用Pearson分析CRP、IL-18与肝损伤的相关性。结果 AOPP组患者外周血CRP和IL-18水平在入院时、入院第1、3及7天时逐渐升高,在第3天时达到最大值,在发病1周后下降,但高于对照组,差异有统计学意义(P<0.05)。中度和重度组患者外周血CRP和IL-18水平高于轻度组,差异有统计学意义(P<0.05),重度组入院第7天CRP和IL-18水平分别是入院时的4.94和2.96倍。AOPP组谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBL)高于对照组,差异有统计学意义(P<0.05),两组清蛋白(ALB)和总蛋白含量差异无统计学意义(P>0.05),但重度组肝功能与轻度组比较,差异有统计学意义(P<0.05)。CRP、IL-18与ALT、AST、TBL呈正相关,而与ALB呈负相关(P<0.05)。结论AOPP患者外周血CRP、IL-18水平与中毒程度、中毒时间和早期肝损伤密切相关,动态观察外周血CRP和IL-18水平变化有助于及时发现患者早期肝功能变化。
]Objective To explore the relationship of peripheral blood levels of C reactive protein （CRP） and interleukin - 18 （IL -18） with early liver damage in those patients with acute organic phosphorus pesticide poisoning （AOPP）. Methods One hundred and twenty - eight cases of AOPP patients, ever treated in our hospital from Mar 2013 to Apr 2016, were selected and enrolled as the AOPP group. They were further divided into the mild poisoning group （n = 36） , the moderate poisoning group （n =45） and the severe poisoning group （n =48） according to their degree of poisoning, and other 56 healthy people underwent physical examination were simultaneously en-rolled as the control group. The peripheral blood levels of CRP and IL - 18, together with the 5 items of liver function （ ALT, AST, TBL, ALB and TP） , were detected at the day of admission and the 1st, 3rd, 7th day after admission, and the relationship of CRP and IL - 18 lev-els with liver damage were conducted by Pearson analysis. Results The levels of CRP and IL - 18 at the day of admission and the 1st, 3rd, 7th day after admission increased gradually in the AOPP group, with peak value at the third day and in decline after the 7th day, and these results at each day were all significantly higher than those in the control group （ all P 〈 0. 05 ）. The levels of CRP and IL - 18 in the moderate and severe poisoning groups were significantly higher than that in the mild poisoning group （P 〈0. 05） , and in the severe poisoning group, levels of CRP and IL - 18 at the 7th day were 4. 94 and 2. 96 times that on admission, respectively. The levels of ALT, AST and TBL in the AOPP group were significantly higher than that in the control group （P 〈 0. 05 ） , and no statistically significant difference was found in the levels of ALB and TB between the two groups （ P 〉 0. 05 ）. But there was significant difference in the liver function between the severe and mild poisoning group （P 〈0. 05）. The levels of CRP and IL - 18 were positively correlated with those of ALT, AST and TBL, and were neg-atively correlated with that of ALB （ P 〈 0. 05 ）. Conclusion The CRP and IL - 18 levels in peripheral blood in those AOPP patients were closely related to their degree of poisoning, poisoning time and early liver damage. Thus, dynamic change monitoring of the peripheral blood CRP and IL - 18 levels would be helpful to identify liver function changes earlier in the AOPP patients.[
出处
《安徽医学》
2017年第8期1008-1011,共4页
Anhui Medical Journal
关键词
急性有机磷农药中毒
C反应蛋白
白细胞介素-18
肝损伤
Acute organic phosphorus pesticide poisoning
C reactive protein
Interleukin - 18
Liver damage
