Jiang Xinrui, Liu Hengjun, Lu Geng, Zhou Jiawei, Wang Jun, Shao Binxia, Xu Peng
Department of Emergency, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Emerg Med Int. 2023 Sep 12;2023:4443680. doi: 10.1155/2023/4443680. eCollection 2023.
The chest computed tomography (CT) examination is an important clinical examination in the diagnosis and monitoring of paraquat- (PQ-) induced lung injury. The aim of this study was to explore the prognostic value of the average lung CT number acquired by quantitative CT techniques in patients with acute paraquat poisoning in the early stages of the disease.
46 patients who suffered from acute PQ poisoning in the emergency department of the Nanjing Drum Tower Hospital from January 2015 to June 2020 were enrolled in the present study. The patients were divided into survival group ( = 21) and nonsurvival group ( = 25). Clinical data were collected from subjects who met the inclusion criteria, including general information, personal disease history, and laboratory test indicators. The average lung CT numbers of each patient were obtained by quantitative CT techniques. Receiver operating characteristic (ROC) analysis was conducted to assess the prognostic value of average lung CT number in patients with acute paraquat poisoning.
The average CT numbers of the middle-lung, lower-lung, and whole lung fields in the nonsurvival group were significantly higher than those of the survival group ( < 0.0001). However, the upper-lung field was not significantly different between the two groups ( = 0.7765). The AUCs of different levels ranged from 0.554 to 0.977, among which the lower-lung field presented the largest AUC of 0.977 (95% CI: 0.943∼1; cut-off value: -702Hu; sensitivity 96%; specificity, 90.5%; YI: 0.865), followed by the whole lung field 0.914 (95% CI: 0.830∼0.999; cut-off value: -727Hu; sensitivity 76%; specificity, 95.2%; YI: 0.712) and the middle-lung field 0.87 (95% CI: 0.768∼0.971; cut-off value: -779Hu; sensitivity 80%; specificity, 85.7%; YI: 0.657).
The present study indicated that the average lung CT number could be used to evaluate the relationship between the severity of PQ-induced lung injury and prognosis, especially in the lower-lung field. However, further research is needed to draw a clear conclusion.
胸部计算机断层扫描（CT）检查是百草枯（PQ）所致肺损伤诊断及监测中的一项重要临床检查。本研究旨在探讨定量CT技术获取的平均肺CT值在急性百草枯中毒患者疾病早期的预后价值。
选取2015年1月至2020年6月在南京鼓楼医院急诊科就诊的46例急性PQ中毒患者纳入本研究。将患者分为存活组（n = 21）和非存活组（n = 25）。收集符合纳入标准受试者的临床资料，包括一般信息、个人疾病史及实验室检查指标。采用定量CT技术获取每位患者的平均肺CT值。进行受试者工作特征（ROC）分析以评估平均肺CT值在急性百草枯中毒患者中的预后价值。
非存活组中肺、下肺及全肺野的平均CT值显著高于存活组（P < 0.0001）。然而，两组上肺野差异无统计学意义（P = 0.7765）。不同层面的曲线下面积（AUC）范围为0.554至0.977，其中下肺野AUC最大，为0.977（95%可信区间：0.943～1；截断值：-702Hu；敏感度96%；特异度90.5%；约登指数：0.865），其次是全肺野0.914（95%可信区间：0.830～0.999；截断值：-727Hu；敏感度76%；特异度95.2%；约登指数：0.712）和中肺野0.87（95%可信区间：0.768～0.971；截断值：-779Hu；敏感度80%；特异度85.7%；约登指数：0.657）。
本研究表明，平均肺CT值可用于评估PQ所致肺损伤严重程度与预后之间的关系，尤其是在下肺野。然而，需要进一步研究以得出明确结论。
