论文部分内容阅读
目的探讨患者血糖水平对急性有机磷农药中毒(AOPP)的预后评估价值。方法选择76例AOPP患者,监测其住院第1、3、5d血糖、胆碱酷酶、各脏器功能损伤情况及预后。根据入院当天静脉血糖水平分为A组18例(血糖3.9～6.1mmol/L)、B组42例(血糖6.1～11.12mmol/L)和C组16例(血糖>11.12mmol/L)。以A-PACHE II评分为标准,分析A、B、C组血糖水平与脏器功能损伤、病情严重程度及预后的关系。结果 C组A-PACHE II评分、CK-MB水平、AMS水平均较A组明显升高(P<0.05),第1、3天CHE水平较A组明显降低(P<0.05),ALT水平较A组明显降低;B组CHE水平较A组明显降低(P<0.01),APACHE II评分虽有升高,但差异无统计学意义。Kendall等级相关分析结果显示,血糖水平与呼吸衰竭、脑损伤(昏迷)、胰腺损伤、消化道出血、死亡均呈正相关(P<0.05),而与肝脏损伤呈负相关(P<0.05);Pearson相关分析显示,血糖水平与APACHEII评分、CK-MB、CR和AMS均呈正相关(P<0.05,P<0.01),与CHE、ALT呈负相关(P<0.05)。结论 AOPP患者血糖水平与脏器损伤、病情严重程度及预后密切相关,可以作为评价重症急性有机磷农药中毒的一个重要指标。
Objective To investigate the prognosis of patients with acute organophosphorus pesticide poisoning (AOPP). Methods AOPP was performed in 76 patients with AOPP. The blood glucose, cholinesterase, dysfunction and prognosis of each organ on the 1st, 3rd, 5th day were monitored. According to the venous blood glucose level on the day of admission, 18 patients in group A (blood glucose 3.9 ~ 6.1mmol / L), 42 patients in group B (6.1 ~ 11.12mmol / L) and 16 patients in group C (blood glucose> 11.12mmol / L) The A-PACHE II score was used as a standard to analyze the relationship between the blood glucose level in group A, B and C, the severity of organ function and prognosis. Results The A-PACHE II score, CK-MB level and AMS level in group C were significantly higher than those in group A (P <0.05). The levels of CHE in group C were significantly lower than those in group A on the first and third days (P <0.05) The level of CHE in group B was significantly lower than that in group A (P <0.01). The APACHE II score was increased, but the difference was not statistically significant. Kendall rank correlation analysis showed that there was a positive correlation between blood glucose and respiratory failure, brain injury (coma), pancreas injury, gastrointestinal bleeding and death (P <0.05), but negatively correlated with liver injury (P <0.05). Pearson Correlation analysis showed that there was a positive correlation between blood glucose level and APACHEII score, CK-MB, CR and AMS (P <0.05, P <0.01) and negative correlation with CHE and ALT (P <0.05). Conclusion The blood glucose level in AOPP patients is closely related to organ injury, severity of disease and prognosis. It can be used as an important index to evaluate severe acute organophosphorus pesticide poisoning.