服毒量对于评估急性百草枯中毒患者预后准确性的探讨Discuss on Prognostic Accuracy of Poisoning Dose in Evaluation of Acute Paraquat Poisoning Patients
蒋臻,许树云,曹钰,胡海,高云峰,陈金刚
摘要(Abstract):
目的探讨服毒量对于评估急性百草枯中毒(APP)患者预后的准确性。方法回顾性分析225例APP患者的年龄、服毒量、血清百草枯浓度及中毒时间,计算服毒量和APP严重指数(SIPP)的受试者工作特征(ROC)曲线下面积,通过服毒量的cutoff值、SIPP、Jones生存回归方程和Proudfoot生存曲线推断患者预后。结果只有百草枯浓度及中毒时间进入Logistic回归方程。服毒量与SIPP的ROC曲线下面积分别为0.784和0.916。中毒200 h内的患者,服毒量除特异性稍高于Jones生存回归方程外,其余诊断性试验指标均最低。中毒4~24 h间的患者,虽然服毒量的特异性、阳性预测值和阳性似然比稍高于Jones生存回归方程,但其敏感性、阴性预测值和准确度均为最低。结论服毒量不能准确评估APP患者的预后,血清百草枯浓度及中毒时间仍是较为可靠的预测指标,在不能测定百草枯浓度的情况下,可通过血乳酸等早期变化的实验室指标对APP患者进行快速的预后评估。
关键词(KeyWords): 百草枯中毒;服毒量;血药浓度;预后
基金项目(Foundation): 国家自然科学基金青年科学基金项目(30900493)
作者(Author): 蒋臻,许树云,曹钰,胡海,高云峰,陈金刚
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