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百草枯中毒的临床特征、治疗、预后及死亡率:伊朗一项基于医院的研究

Clinical Features, Treatment, Prognosis, and Mortality in Paraquat Poisonings: A Hospital-Based Study in Iran.

作者信息

Oghabian Zohreh, Williams June, Mohajeri Mohammad, Nakhaee Samaneh, Shojaeepour Saeedeh, Amirabadizadeh Alireza, Elhamirad Samira, Hajihosseini Morteza, Mansouri Borhan, Mehrpour Omid

机构信息

Department of Clinical Toxicology, Gastroenterology and Hepatology Research Center, Kerman University of Medical Science, Kerman, Iran.

Department of Paraclinical Sciences, University of Pretoria, Pretoria, South Africa.

出版信息

J Res Pharm Pract. 2019 Oct 16;8(3):129-136. doi: 10.4103/jrpp.JRPP_18_71. eCollection 2019 Jul-Sep.

Abstract

OBJECTIVE

The aim of the present study was to evaluate the demographics, clinical characteristics, fatal dose, the efficacy of treatments, and prognosis in paraquat (PQ) poisoning in the Kerman Province of Iran.

METHODS

This analytical cross-sectional study was conducted on 126 PQ poisoned patients who were referred to Afzalipour Hospital during 2006-2015. Demographic variables such as age and gender, signs and symptoms of poisoning, the estimated ingested dosage of PQ, and clinical outcome were extracted from medical records. Patients were compared and categorized into two groups considering the outcome: survivors and nonsurvivors. Patients with nonoral exposures, combined drug exposures, PQ exposures more than 24 h before the presentation, and critical underlying diseases were not included in the study.

FINDINGS

Our results indicated that the mean dose of PQ used by all patients was 2358 mg, which was reported as 1846 and 2812 mg in females and males, respectively. Moreover, the results showed that the highest mortality rate was in patients with respiratory distress, followed by oral ulceration and excess salivation. In all PQ-poisoned patients, the dose of greater than approximately 2250 mg predicted death with 86.2% specificity and 75.7% sensitivity.

CONCLUSION

Based on the results of the present study, the mortality rate in PQ-poisoned patients depended on the dose of poison, blood sugar level, and aspartate transaminase levels. Our results suggest that these parameters have excellent prognostic value for the prediction of mortality.

摘要

目的

本研究旨在评估伊朗克尔曼省百草枯(PQ)中毒患者的人口统计学特征、临床特点、致死剂量、治疗效果及预后情况。

方法

本分析性横断面研究选取了2006年至2015年期间转诊至阿夫扎利普尔医院的126例百草枯中毒患者。从病历中提取年龄、性别等人口统计学变量、中毒的体征和症状、估计摄入的百草枯剂量以及临床结局。根据结局将患者分为两组进行比较:存活者和非存活者。非经口暴露、合并药物暴露、就诊前24小时以上的百草枯暴露以及严重基础疾病患者未纳入本研究。

结果

我们的结果表明,所有患者使用的百草枯平均剂量为2358毫克,女性和男性分别报告为1846毫克和2812毫克。此外,结果显示呼吸窘迫患者的死亡率最高,其次是口腔溃疡和唾液过多。在所有百草枯中毒患者中,大于约2250毫克的剂量预测死亡的特异性为86.2%,敏感性为75.7%。

结论

基于本研究结果,百草枯中毒患者的死亡率取决于中毒剂量、血糖水平和天冬氨酸转氨酶水平。我们的结果表明,这些参数对预测死亡率具有极好的预后价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b07f/6830018/cc62d57b5076/JRPP-8-129-g001.jpg

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