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血清肌酸磷酸激酶在中毒患者预后预测中的作用;简要报告

Role of Serum Creatinine Phosphokinase in Outcome Prediction of Intoxicated Patients; a Brief Report.

作者信息

Dadpour Bita, Tajoddini Shahrad, Shaarbaf Eidgahi Elham, Shokouhizadeh Mohsen, Shafahi Azam

机构信息

Medical Toxicology Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

Emerg (Tehran). 2017;5(1):e63. Epub 2017 Mar 4.

Abstract

INTRODUCTION

Several mechanisms were introduced as causes of serum creatinine phosphokinase (CPK) raise in intoxicated patients. This study aimed to assess the relationship between serum CPK level in the first 24 hours and baseline characteristics as well as outcomes of these patients.

METHODS

This one year retrospective cross-sectional study was conducted on all intoxicated patients, who were admitted to a referral toxicology center, Northwest of Iran, stayed for at least 24 hours and had serum CPK level more than 500 IU/L in the first 24 hours of admission. The relationship between serum CPK level and some baseline and outcome variables were studied using SPSS version 21.

RESULTS

413 patients with the mean age of 34.52 ± 15.24 years were studied (78.7% male). The mean CPK level at the time of presentation to ED was 3702.85 ± 6375.29 IU/L. There was not any significant relationship between presenting CPK level and type of poisoning (p = 0.258), sex (p = 0.587), and age (p = 0.817). The area under the ROC curve of CPK in prediction of need for dialysis, need for intensive care unit (ICU) admission, and mortality was 0.67 (95% CI: 0.57 - 0.77), 0.60 (95% CI: 0.52 - 0.69), and 0.60 (95% CI: 0.51 - 0.68), respectively.

CONCLUSION

Based on the finding of present study, there was no significant association between serum CPK level in the first 24 hours and age, sex, and type of poisoning of intoxicated patients and it had poor accuracy in prediction of their need to do dialysis, need for ICU admission, and mortality.

摘要

引言

有几种机制被认为是中毒患者血清肌酸磷酸激酶(CPK)升高的原因。本研究旨在评估中毒患者入院后首24小时内血清CPK水平与基线特征及预后之间的关系。

方法

本项为期一年的回顾性横断面研究纳入了所有入住伊朗西北部一家转诊毒理学中心的中毒患者,这些患者至少住院24小时,且入院后首24小时内血清CPK水平超过500 IU/L。使用SPSS 21版软件研究血清CPK水平与一些基线及预后变量之间的关系。

结果

共研究了413例患者,平均年龄为34.52±15.24岁(78.7%为男性)。患者就诊于急诊科时的平均CPK水平为3702.85±6375.29 IU/L。就诊时的CPK水平与中毒类型(p = 0.258)、性别(p = 0.587)及年龄(p = 0.817)之间均无显著关系。CPK预测透析需求、重症监护病房(ICU)入住需求及死亡率的ROC曲线下面积分别为0.67(95%可信区间:0.57 - 0.77)、0.60(95%可信区间:0.52 - 0.69)及0.60(95%可信区间:0.51 - 0.68)。

结论

基于本研究结果,中毒患者入院后首24小时内血清CPK水平与年龄、性别及中毒类型之间无显著关联,且在预测其透析需求、ICU入住需求及死亡率方面准确性较差。

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