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目的研究B型利钠肽(BNP)联合降钙素原(PCT)测定对有机磷农药中毒患者监控的临床价值。方法 50例有机磷农药中毒患者,给予所有患者行催吐、洗胃、导泻、气管插管、机械通气、抗感染等常规对症处理,对患者进行血浆BNP和血浆PCT连续监测的数据改变情况及病情变化进行比较,分析BNP与PCT测定在有机磷农药中毒患者中的数据变化与患者疾病转归的关联性。结果通过对患者监测BNP及PCT,50例中毒患者中有34例患者BNP测定结果持续增高(A组),其PCT结果亦升高,提示BNP升高患者细菌感染情况相对较普遍,平均住院时间为(15.0±2.1)d;16例患者BNP一过性升高(B组),PCT结果低于A组,住院时间为(9.0±1.3)d短于A组,差异有统计学意义(P<0.05)。主动服用的患者BNP及PCT指标高于误服或呼吸道吸入患者,治疗时间多于误服或呼吸道吸入患者,差异有统计学意义(P<0.05)。结论 BNP联合PCT测定对有机磷农药中毒患者临床诊疗有积极意义,有机磷农药中毒患者存在不同程度的心肌损伤及细菌感染状态。
Objective To investigate the clinical value of BNP combined with procalcitonin (PCT) in the monitoring of organophosphorus pesticide poisoning patients. Methods 50 patients with organophosphorus pesticide poisoning were given to all patients with routine symptomatic treatment such as vomiting, gastric lavage, catharsis, endotracheal intubation, mechanical ventilation and anti-infective. Data of patients with plasma BNP and plasma PCT were monitored. The changes of the disease were compared to analyze the relationship between the changes of BNP and PCT in patients with organophosphorus pesticide poisoning and the prognosis of patients. Results BNP and PCT were monitored in patients with BNP. The results of BNP in 34 patients with 50 poisoning cases continued to increase (A group), and the PCT results also increased. The results suggested that the prevalence of bacterial infection in patients with elevated BNP was relatively common, the average length of stay (15.0 ± 2.1) d. The BNP level was increased in 16 patients (group B), the PCT results were lower than those in group A, and the hospital stay was (9.0 ± 1.3) d shorter than that in group A (P <0.05). The active BNP and PCT indexes were higher than those of patients taking inhaled air or inhaled air more than the patients taking it by mistake or taking inhaled air. The difference was statistically significant (P <0.05). Conclusion The combination of BNP and PCT has positive significance in the clinical diagnosis and treatment of patients with organophosphorus pesticide poisoning. Patients with organophosphate pesticide poisoning have different degree of myocardial injury and bacterial infection.