Wang Wei-hua, Zhang Hui, Yu Yan-lin, Jiang Jing-han, Xue Cheng
Department of Emergency Medicine, Yijishan Hospital, Wannan Medical College, Wuhu 241000, Anhui, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2005 May;17(5):293-5.
To investigate the relationship between endothelin (ET) and multiple organ dysfunction syndrome (MODS) caused by acute paraquat poisoning (APP).
The levels of plasma ET were measured by radioimmunoassay in 24 patients with MODS caused by APP and 19 healthy persons as controls. The levels of plasma ET patients in MODS caused by APP were correlatively analysed with acute physiology and chronic health evaluation II (APACHE II) score, partial pressure of oxygen in artery (PaO2), troponin I (cTnI) level, blood enzymology and biochemistry indexes.
The levels of plasma ET in patients with MODS caused by APP were much higher than controls (P<0.01), the level of plasma ET in death group was much higher than that of survivor group (P<0.01). Plasma ET was positively correlated with APACHE II score, cTnI, MB isoenzyme of creatine kinase (CK-MB), lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN) and serum creatinine (SCr, P<0.05 or P<0.01), where there was a negative correlation with PaO2 (P<0.01).
Endothelin may be involved in the pathogenesis of MODS caused by APP, plasma ET may be one of a clinical index for evaluating the degree of multiple organ function damage, for guiding treatment, and judging the prognosis of MODS caused by APP.
探讨内皮素(ET)与急性百草枯中毒(APP)所致多器官功能障碍综合征(MODS)之间的关系。
采用放射免疫法测定24例APP所致MODS患者及19名健康对照者血浆ET水平。对APP所致MODS患者血浆ET水平与急性生理与慢性健康状况评分系统II(APACHE II)评分、动脉血氧分压(PaO2)、肌钙蛋白I(cTnI)水平、血液酶学及生化指标进行相关性分析。
APP所致MODS患者血浆ET水平显著高于对照组(P<0.01),死亡组血浆ET水平显著高于存活组(P<0.01)。血浆ET与APACHE II评分、cTnI、肌酸激酶同工酶MB(CK-MB)、乳酸脱氢酶(LDH)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血尿素氮(BUN)及血清肌酐(SCr)呈正相关(P<0.05或P<0.01),与PaO2呈负相关(P<0.01)。
内皮素可能参与APP所致MODS的发病机制,血浆ET可能是评估多器官功能损害程度、指导治疗及判断APP所致MODS预后的临床指标之一。