1 Emergency Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
2 Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford, UK.
Hum Exp Toxicol. 2019 Sep;38(9):1024-1030. doi: 10.1177/0960327119851252. Epub 2019 May 19.
Paraquat (PQ) poisoning is a significant cause of mortality and morbidity in developing countries. Poor prognostic outcomes have been attributed to the herbicide's toxicity and the lack of effective treatments. Our study aims to investigate the changes in lymphocyte count in both patients who survived and died from PQ poisoning and explore the prognostic value.
This is a retrospective case serials observational study. Adult patients admitted with acute PQ poisoning. The notes of 1000 patients who presented with acute PQ poisoning were reviewed. One hundred thirty patients having the T lymphocyte met the inclusion criteria and were grouped into those that survived the poisoning (95) and non-survivors (35).
On admission, non-survivors had a higher ingestion volume of PQ and urine PQ concentration as well as higher severity indices (Acute Physiology and Chronic Health Evaluation 2, Sequential Organ Failure Assessment, and Poisoning Severity Score). Patients in the survival group had a higher dosage of immunosuppressant and a longer hospital stay. Leukocytes, especially neutrophils, were higher among non-survivors; however, the converse was found with lymphocytes. T lymphocyte (CD3) count was consistently higher among survivors as well as the subgroups CD4+ and CD8+. No differences in the ratio of CD4/CD8 were found between the groups.
Our study has shown that changes in lymphocyte count as its subgroups could indicate a host's immune status and lymphocytes play an important role as a surrogate marker of host immunity, which could be a useful prognostic tool in the assessment of this disease.
百草枯（PQ）中毒是发展中国家导致死亡率和发病率的一个重要原因。不良预后归因于除草剂的毒性和缺乏有效治疗。本研究旨在探讨存活和死于 PQ 中毒患者的淋巴细胞计数变化，并探讨其预后价值。
这是一项回顾性病例系列观察性研究。纳入急性 PQ 中毒住院的成年患者。回顾了 1000 例急性 PQ 中毒患者的病历。130 名符合 T 淋巴细胞纳入标准的患者被分为中毒存活组（95 例）和非存活组（35 例）。
入院时，非存活组 PQ 摄入量、尿 PQ 浓度以及严重程度指数（急性生理学和慢性健康评估 2 评分、序贯器官衰竭评估评分和中毒严重程度评分）较高。存活组患者免疫抑制剂剂量较高，住院时间较长。非存活组白细胞，尤其是中性粒细胞较高，但淋巴细胞则相反。T 淋巴细胞（CD3）计数在存活组及 CD4+和 CD8+亚组中均较高。两组间 CD4/CD8 比值无差异。
本研究表明，淋巴细胞计数及其亚群的变化可能表明宿主的免疫状态，淋巴细胞作为宿主免疫的替代标志物起着重要作用，这可能是评估这种疾病的有用预后工具。
