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目的 :探讨百草枯(paraquat,PQ)中毒患者的早期胸部CT表现对预后的评估。方法 :回顾性分析74例具有完整临床资料的急性百草枯中毒患者的早期(≤7 d)胸部CT图像。通过自建半定量评分表对百草枯中毒患者早期胸部CT的磨玻璃密度影、实变影、纤维化、胸腔积液、纵隔气肿进行评分,绘制受试者特征(ROC)曲线评估胸部CT半定量评分的预测性能和最佳诊断界值。结果:生存组40例,平均(2.35±1.81)分,死亡组34例,平均(8.74±3.70)分,两组评分有差异(P≤0.001)。ROC曲线下面积0.930,以得分≥分6为界点,则诊断敏感度、特异度分别为76.5%、97.5%。结论:胸部CT半定量评分综合分析百草枯中毒患者早期肺损伤的影像学特征,对预后生存及死亡有较好的评估价值。
Objective: To investigate the prognostic value of early chest CT findings in patients with paraquat poisoning. Methods: Early (≤7 days) chest CT images of 74 acute paraquat poisoning patients with complete clinical data were retrospectively analyzed. The self-built semi-quantitative scoring table was used to evaluate the ground-glass density, consolidation, fibrosis, pleural effusion and mediastinal emphysema in early chest CT in patients with paraquat poisoning. The receiver operating characteristic (ROC) Semi-quantitative score predictive performance and best diagnostic cutoff. Results: There were 40 survivors (mean 2.35 ± 1.81) and 34 deaths (mean, 8.74 ± 3.70). There were significant differences between the two groups (P≤0.001). The area under the ROC curve was 0.930. If the score ≥ 6 points, the diagnostic sensitivity and specificity were 76.5% and 97.5% respectively. Conclusion: The semi-quantitative CT scoring of chest CT can comprehensively analyze the imaging features of early lung injury in patients with paraquat poisoning, which has a good evaluation value for prognosis and death.