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[三种方法在急性百草枯中毒严重程度评估及预后中的预测价值]

[Predictive value of 3 methods in severity evaluation and prognosis of acute paraquat poisoning].

作者信息

Du Yu, Mou Yi

机构信息

Emergency Department, No.4 West China Teathing Hospital,Sichuan University, Chengdu 610041, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2013 Jul;38(7):737-42. doi: 10.3969/j.issn.1672-7347.2013.07.014.

Abstract

OBJECTIVE

To evaluate the predictive value of 3 methods, namely plasma paraquat concentration, severity index of paraquat poisoning (SIPP), and acute physiology and chronic health evaluation (APACHE II) in severity evaluation and prognosis of acute paraquat poisoning.

METHODS

A total of 73 acute paraquat poisoning patients with oral administration were collected. Paraquat concentration in the plasma and other parameters on admission for SIPP and APACHE II were taken from medical records. According to the clinical outcome in the hospital or 7 days after the discharge, discrimination and calibration test were performed to evaluate the prognosis of the 3 methods.

RESULTS

Discrimination of the 3 methods was greater than 0.8, and the area under the receiver operator curve for SIPP (0.938) was greater than paraquat concentration in the plasma (0.857) and APACHE II (0.801) with statistical significance (z=2.429, 2.021; P=0.015, 0.043). Difference in plasma paraquat concentration (0.857) and APACHE II (0.801) had no statistical significance (z=0.755, P=0.450). Hosmer-Lemeshow good fit test suggested better calibration value with statistical significance for the 3 methods (P>0.05).

CONCLUSION

The 3 methods are valid in the severity evaluation and prognosis of acute paraquat poisoning. SIPP is the most preferred method, followed by paraquat concentration on admission. When there is no facility to measure paraqut concentration, APACHE II can be used as a reference for the death risk in acute paraquat poisoning.

摘要

目的

评估血浆百草枯浓度、百草枯中毒严重程度指数(SIPP)和急性生理与慢性健康状况评分系统(APACHE II)这三种方法在急性百草枯中毒严重程度评估及预后判断中的预测价值。

方法

收集73例口服急性百草枯中毒患者。从病历中获取血浆百草枯浓度以及入院时SIPP和APACHE II的其他参数。根据患者在医院的临床结局或出院后7天的情况,进行判别和校准测试以评估这三种方法的预后。

结果

三种方法的判别度均大于0.8,SIPP的受试者工作特征曲线下面积(0.938)大于血浆百草枯浓度(0.857)和APACHE II(0.801),差异具有统计学意义(z = 2.429,2.021;P = 0.015,0.043)。血浆百草枯浓度(0.857)与APACHE II(0.801)之间的差异无统计学意义(z = 0.755,P = 0.450)。Hosmer-Lemeshow拟合优度检验表明这三种方法的校准值较好,具有统计学意义(P>0.05)。

结论

这三种方法在急性百草枯中毒严重程度评估及预后判断中均有效。SIPP是最优选的方法,其次是入院时的百草枯浓度。当没有检测百草枯浓度的设备时,APACHE II可作为急性百草枯中毒死亡风险的参考。

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