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目的探讨动脉血乳酸预测急性百草枯中毒患者预后的价值。方法根据出院30d后的随访结果,急性百草枯中毒患者35例分为存活组(12例)和死亡组(23例),回顾性分析两组患者的住院资料,绘制入院时和入院24h的受试者工作特征曲线,分析动脉血乳酸值预测预后的灵敏度和特异度。结果入院时存活组服毒-洗胃时间短于死亡组[(4.2±0.3)h vs.(4.9±0.5)h],且动脉血乳酸值低于死亡组[(1.6±0.9)mmol/L vs.(3.8±1.1)mmol/L](P<0.05)。入院时动脉血乳酸曲线下面积(AUC)为0.93,临界值为2.63mmol/L时,高乳酸患者死亡例数多于低乳酸患者(P<0.05),灵敏度为86.9%、特异度为91.7%。入院24h后,动脉血乳酸AUC为0.78,临界值为2.24mmol/L时,高乳酸患者死亡例数多于低乳酸患者(P<0.05),灵敏度为77.9%、特异度为52.2%。结论早期动脉血乳酸值判断急性百草枯中毒患者预后有较好的预测价值。
Objective To investigate the value of arterial lactate in predicting the prognosis of patients with acute paraquat poisoning. Methods According to the follow-up results after 30 days of discharge, 35 patients with acute paraquat poisoning were divided into survival group (12 cases) and death group (23 cases). The hospitalization data of two groups were retrospectively analyzed. The working characteristic curve of the test subjects was used to analyze the sensitivity and specificity of predicting the prognosis of arterial blood lactate. Results Compared with the death group [(4.2 ± 0.3) h vs. (4.9 ± 0.5) h], the lavage time of the surviving group on admission was lower than that of the death group [(1.6 ± 0.9) mmol / L vs (3.8 ± 1.1) mmol / L] (P <0.05). The area under curve of arterial blood lactate (AUC) was 0.93 and the critical value was 2.63mmol / L at admission, the number of deaths in patients with high lactic acid was higher than that in patients with low lactic acid (P <0.05), the sensitivity was 86.9% and the specificity was 91.7% . After 24h of admission, the lactic acid AUC was 0.78 and the critical value was 2.24mmol / L, the number of deaths in patients with high lactic acid was more than that in patients with low lactic acid (P <0.05). The sensitivity and specificity were 77.9% and 52.2% respectively. Conclusion Early arterial blood lactate to determine the prognosis of patients with acute paraquat poisoning has a better prognosis.