Lee Ching-Hsing, Shih Chia-Pang, Hsu Kuang-Hung, Hung Dong-Zong, Lin Chih-Chuan
Department of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan Hsien, Taiwan 333.
Am J Emerg Med. 2008 Mar;26(3):275-81. doi: 10.1016/j.ajem.2007.05.011.
The purpose of this study was to establish an early prognostic model of patients with glyphosate-surfactant (GlySH) herbicide intoxication.
A case-control study was conducted. Data of GlySH-intoxicated patients were collected from 2 hospitals. Patients were admitted to the emergency departments (EDs) of Chang Gung Memorial Hospital from April 1996 to March 2003 and Taichung Veterans General Hospital from April 2000 to October 2003. Collected variables such as age, sex, estimated amount of ingestion, symptoms/signs including first vital signs, chest x-ray (CXR), and biochemical studies were analyzed for their role in the prognostic model of GlySH intoxication mortality. Univariate and odds ratio analyses were then performed. The prognostic model was then established by using logistic regression analysis and further stratified analysis.
Fifty-eight patients (19 men and 39 women; age, 48.8 +/- 15.8 years; P = .38) were enrolled in our study. Forty-one patients survived from GlySH intoxication and 17 died. After univariate analysis, 5 variables (respiratory distress needing intubation, metabolic acidosis, tachycardia, elevated creatinine (Cr) level, and hyperkalemia) were found to be highly associated with poor outcome and mortality. Then a multiple logistic regression model was established as follows: log(p/q) = -6.13 + 3.43 (abnormal CXR) + 2.53 (metabolic acidosis) + 2.55 (Cr) + 2.4 (tachycardia) + e.
GlySH poisoning is multiorgan toxicity. Pulmonary toxicity and renal toxicity seem to be responsible for its mortality. Metabolic acidosis, abnormal CXR, tachycardia, and elevated Cr level are useful prognostic factors for predicting GlySH mortality.
本研究旨在建立草甘膦-表面活性剂（GlySH）除草剂中毒患者的早期预后模型。
进行了一项病例对照研究。收集了两家医院GlySH中毒患者的数据。1996年4月至2003年3月长庚纪念医院急诊科以及2000年4月至2003年10月台中荣民总医院急诊科收治了这些患者。分析收集的变量，如年龄、性别、估计摄入量、症状/体征（包括首次生命体征、胸部X线（CXR））以及生化检查结果在GlySH中毒死亡率预后模型中的作用。随后进行单因素分析和比值比分析。然后使用逻辑回归分析和进一步的分层分析建立预后模型。
本研究纳入了58例患者（19例男性和39例女性；年龄48.8±15.8岁；P = 0.38）。41例患者从GlySH中毒中存活，17例死亡。单因素分析后，发现5个变量（需要插管的呼吸窘迫、代谢性酸中毒、心动过速、肌酐（Cr）水平升高和高钾血症）与不良结局和死亡率高度相关。随后建立了如下多元逻辑回归模型：log(p/q)= -6.13 + 3.43（异常CXR）+ 2.53（代谢性酸中毒）+ 2.55（Cr）+ 2.4（心动过速）+ e。
GlySH中毒具有多器官毒性。肺毒性和肾毒性似乎是其死亡率的原因。代谢性酸中毒、异常CXR、心动过速和Cr水平升高是预测GlySH死亡率的有用预后因素。
