Tang Y H, Chen K Y, Hu Y C, Li M X, Yin R, Lu Z Q
Department of Emergency Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China Wenzhou Key Laboratory of Emergency and Disaster Medicine, Wenzhou 325000, China.
Department of Emergency Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2023 Jul 20;41(7):528-533. doi: 10.3760/cma.j.cn121094-20220311-00124.
To investigate the predictive value of serum lactate dehydrogenase (LDH) in the prognosis of patients with paraquat (PQ) poisoning, and to provide evidence for early prognosis assessment. In February 2022, 50 patients with PQ poisoning who completed serum LDH detection admitted to the Department of Emergency Medicine, the First Affiliated Hospital of Wenzhou Medical University from January 2012 to December 2021 were selected as the observation group, and 50 healthy physical examination personnel were randomly selected as the control group. Patients with PQ poisoning were divided into survival group and death group according to the prognosis, and the differences of blood routine routine, liver and kidney function and other indicators in the first admission between the two groups were compared. Multivariate logisitic regression model was established, ROC curve was drawn, and the influencing factors of prognosis of patients with PQ poisoning were analyzed. Compared with the control group, the white blood cell count (WBC), total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), LDH, glucose (GLU) and creatinine (Cr) in observation group were significantly increased, while albumin (ALB) and total cholesterol (TC) were significantly decreased (<0.05). Univariate analysis showed that WBC, elevated LDH (>247 U/L), TBil, ALT, AST and Cr were significantly different between PQ poisoning survival group and death group (<0.05). Multivariate logisitic regression analysis showed that elevated serum LDH was an independent risk factor for the prognosis of PQ poisoning patients (=9.95, 95%: 1.34-73.82, =0.025). The area under the ROC curve of LDH was 0.811 (95%: 0.692-0.930). When the cut-off value was 340 U/L, the sensitivity was 0.889 and the specificity was 0.719. Log-rank test showed that there was a statistically significant difference in survival rate between the normal LDH group and the elevated LDH group (=0.001) . Serum LDH has a good predictive value in evaluating the prognosis of patients with PQ poisoning. Elevated LDH is a risk factor for poor prognosis of patients with PQ poisoning.
探讨血清乳酸脱氢酶（LDH）对百草枯（PQ）中毒患者预后的预测价值，为早期预后评估提供依据。选取2012年1月至2021年12月在温州医科大学附属第一医院急诊科住院并完成血清LDH检测的50例PQ中毒患者作为观察组，随机选取50例健康体检人员作为对照组。将PQ中毒患者按预后分为存活组和死亡组，比较两组首次入院时血常规、肝肾功能等指标的差异。建立多因素logisitic回归模型，绘制ROC曲线，分析PQ中毒患者预后的影响因素。与对照组比较，观察组白细胞计数（WBC）、总胆红素（TBil）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、LDH、葡萄糖（GLU）和肌酐（Cr）明显升高，白蛋白（ALB）和总胆固醇（TC）明显降低（<0.05）。单因素分析显示，PQ中毒存活组与死亡组WBC、LDH升高（>247 U/L）、TBil、ALT、AST及Cr差异有统计学意义（<0.05）。多因素logisitic回归分析显示，血清LDH升高是PQ中毒患者预后的独立危险因素（=9.95，95%：1.34 - 73.82，=0.025）。LDH的ROC曲线下面积为0.811（95%：0.692 - 0.930）。当截断值为340 U/L时，敏感度为0.889，特异度为0.719。Log-rank检验显示，LDH正常组与升高组生存率差异有统计学意义（=0.001）。血清LDH对评估PQ中毒患者预后有较好的预测价值。LDH升高是PQ中毒患者预后不良的危险因素。
