Chen J, Zhu J, Liu X T, Wang L, Qi H N, Ma G Y
Hengshui peoples Hospital EICU, Hengshui 053000, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2021 Sep 20;39(9):671-674. doi: 10.3760/cma.j.cn121094-20200627-00327.
To explore the value of soluble growth stimulation expression gene 2 protein (soluble suppression of tumorigenicity 2; sST2) and N terminal B type brain natriuretic peptide (N-terminal probrainnatriuretic peptide, NT-proBNP) in evaluating the short-term prognosis of acute organophosphorus pesticide poisoning. select 228 patients with acute organophosphorus pesticide poisoning in our hospital from October 2017 to March 2020. According to the grade of poisoning degree, it was divided into 82 cases in mild and moderate group and 146 cases in severe group. hs-cTnI、CK-MB、sST2、NT-proBNP、APACHE Ⅱ score and cholinesterase activity were detected 4 h、12 h、24 h after admission. ROC curve was used to evaluate sST2 and NT-proBNP to predict the prognosis of AOPP. 4 hours after admission, there was no significant difference in the scores of hs-cTnI, APACHE Ⅱ, cholinesterase and CK-MB between the Severe Group and the mild and moderate Group (<0.05) . At 12 and 24 hours after admission, the scores of hs-cTnI, CK-MB and APACHE Ⅱ in severe group were higher than those in mild and moderate group, and the changes of Cholinesterase were more significant than those in 12 hours after Admission (<0.05) . 4 hours after admission, SST2 and NT-proBNP levels were significantly higher in severe group than those in mild and moderate Group (<0.05) . The level of SST2 and NT-proBNP in the severe group was significantly higher than that in the mild and moderate group 12 and 24 hours after Admission (<0.01) , and the level of SST2 and NT-proBNP was significantly higher than that in the mild group 12 hours after Admission (<0.05) . Correlation analysis showed that 24 hours after admission, sST2, NT-proBNP were positively correlated with APACHE-Ⅱ scores (=0.634, 0.723, <0.01) . The area under sST2 combined with NT-proBNP was 0.891, higher than that under sST2 and NT-proBNP at 12 h after admission. The 24 h APACHE Ⅱ score after admission area under the curve was 0.838. sST2 and NT-proBNP combined detection can early predict the occurrence of recent complications in AOPP patients.
探讨可溶性生长刺激表达基因2蛋白（可溶性肿瘤抑制因子2；sST2）和N末端B型脑钠肽（N末端脑钠肽前体，NT-proBNP）在评估急性有机磷农药中毒短期预后中的价值。选取2017年10月至2020年3月我院收治的228例急性有机磷农药中毒患者。根据中毒程度分级，分为轻度和中度组82例，重度组146例。于入院后4 h、12 h、24 h检测超敏肌钙蛋白I（hs-cTnI）、肌酸激酶同工酶（CK-MB）、sST2、NT-proBNP、急性生理与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分及胆碱酯酶活性。采用受试者工作特征（ROC）曲线评估sST2和NT-proBNP对急性有机磷农药中毒（AOPP）预后的预测价值。入院后4 h，重度组与轻度和中度组hs-cTnI、APACHEⅡ、胆碱酯酶及CK-MB评分比较，差异无统计学意义（P<0.05）。入院后12 h和24 h，重度组hs-cTnI、CK-MB及APACHEⅡ评分高于轻度和中度组，胆碱酯酶变化较入院后12 h更显著（P<0.05）。入院后4 h，重度组sST2和NT-proBNP水平显著高于轻度和中度组（P<0.05）。入院后12 h和24 h，重度组sST2和NT-proBNP水平显著高于轻度和中度组（P<0.01），入院后12 h重度组sST2和NT-proBNP水平显著高于轻度组（P<0.05）。相关性分析显示，入院后24 h，sST2、NT-proBNP与APACHE-Ⅱ评分呈正相关（r=0.634、0.723，P<0.01）。sST2联合NT-proBNP曲线下面积为0.891，高于入院后12 h sST2和NT-proBNP单独检测时的曲线下面积。入院后24 h APACHEⅡ评分曲线下面积为0.838。sST2和NT-proBNP联合检测可早期预测AOPP患者近期并发症的发生。
