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目的探讨急性百草枯中毒患者血清尿酸水平变化及其意义。方法检测133例急性百草枯中毒患者入院时血清尿酸水平。根据本实验室尿酸的参考范围,将不同性别的患者根据尿酸水平进一步分组分析。结果高尿酸组白细胞、谷丙转氨酶、谷草转氨酶、乳酸脱氢酶、磷酸肌酸激酶和肌酐水平明显高于低尿酸组(P<0.05),而血液酸碱度和二氧化碳分压明显低于后者(P<0.01)。血清尿酸水平与百草枯口服剂量及就诊时间密切相关。百草枯中毒死亡组血清尿酸水平明显高于幸存组(P<0.01)。Kaplan-Meier生存曲线分析结果显示高尿酸组患者28天生存率明显低于低尿酸组(P<0.01)。结论血清尿酸水平对于判断急性百草枯中毒预后有一定的价值,且其活性升高跟不良预后有一定相关。
Objective To investigate the changes of serum uric acid in patients with acute paraquat poisoning and its significance. Methods Serum uric acid levels in 133 patients with acute paraquat poisoning were measured at admission. According to the reference range of uric acid in our laboratory, patients of different genders were further grouped according to uric acid level. Results The levels of leukocyte, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase and creatinine in hyperuricemia group were significantly higher than those in low uric acid group (P <0.05), while the blood pH and CO2 partial pressure were significantly lower than those in the latter P <0.01). Serum uric acid levels and paraquat oral dose and time are closely related. Serum uric acid levels in the paraquat poisoned group were significantly higher than those in the survivor group (P <0.01). Kaplan-Meier survival curve analysis showed that the 28-day survival rate in patients with hyperuricemia was significantly lower than that in patients with low uric acid (P <0.01). Conclusions Serum uric acid level has certain value for judging the prognosis of acute paraquat poisoning, and its activity is correlated with poor prognosis.