Dong Qian, Xu Huan, Xu Pengjie, Liu Jiang
Department of Nephrology, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China.
Biomol Biomed. 2025 Aug 5;25(9):2058-2066. doi: 10.17305/bb.2025.11891.
Paraquat (PQ) is a highly effective herbicide widely used in agricultural production, known for its strong herbicidal power, rapid action, and minimal environmental pollution. However, it is also highly toxic to humans and animals, with acute lung injury (ALI) being the primary cause of death. While the toxic mechanisms of PQ have been studied from various perspectives, its effects on lymphocytes and their subsets remain unclear. This study aimed to explore the relationship between lymphocyte dysfunction and mortality in acute PQ poisoning. A total of 92 patients with PQ poisoning who visited the emergency department of The Affiliated Lihuili Hospital of Ningbo University between January 1, 2016, and September 30, 2021, were included. Basic demographic and laboratory data within 24 h of admission were collected. Peripheral blood lymphocyte subsets were analyzed using flow cytometry. To identify independent risk factors for mortality, patients were followed up for 90 days. COX proportional hazards models and LASSO regression were applied to screen for predictive variables and develop a predictive model. All participants provided informed consent, and the study was approved by the relevant ethics committee. Among the 92 patients, 36 died. Compared with the survival group, the death group showed significantly higher white blood cell and neutrophil counts, lymphocyte counts, and CD4+/CD8+ T cell ratios, while the percentage of natural killer (NK) cells was significantly lower (P < 0.001). COX regression analysis identified these factors as independent risk factors for mortality: lymphocyte count: hazard ratio (HR) = 1.59; 95% confidence interval (CI), 1.02-2.47; P = 0.04 neutrophil count: HR = 1.12; 95% CI, 1.06-1.18; P = 0.04 CD4+/CD8+ T cell ratio: HR = 2.01; 95% CI, 1.03-3.92; P = 0.04 NK cell percentage: HR = 0.88; 95% CI, 0.82-0.95; P = 0.002. These findings suggest that lymphocyte count, neutrophil count, CD4+/CD8+ T cell ratio, and NK cell percentage are all associated with mortality in PQ poisoning cases.
百草枯（PQ）是一种在农业生产中广泛使用的高效除草剂，以其强大的除草能力、快速的作用和最小的环境污染而闻名。然而，它对人类和动物也具有高毒性，急性肺损伤（ALI）是主要死因。虽然已从多个角度研究了PQ的毒性机制，但其对淋巴细胞及其亚群的影响仍不清楚。本研究旨在探讨急性PQ中毒时淋巴细胞功能障碍与死亡率之间的关系。纳入了2016年1月1日至2021年9月30日期间在宁波大学附属李惠利医院急诊科就诊的92例PQ中毒患者。收集入院24小时内的基本人口统计学和实验室数据。使用流式细胞术分析外周血淋巴细胞亚群。为了确定死亡率的独立危险因素，对患者进行了90天的随访。应用COX比例风险模型和LASSO回归筛选预测变量并建立预测模型。所有参与者均提供了知情同意书，该研究获得了相关伦理委员会的批准。92例患者中，36例死亡。与存活组相比，死亡组的白细胞、中性粒细胞计数、淋巴细胞计数和CD4+/CD8+T细胞比值显著更高，而自然杀伤（NK）细胞百分比显著更低（P<0.001）。COX回归分析确定这些因素为死亡率的独立危险因素：淋巴细胞计数：风险比（HR）=1.59；95%置信区间（CI），1.02-2.47；P=0.04；中性粒细胞计数：HR=1.12；95%CI，1.06-1.18；P=0.04；CD4+/CD8+T细胞比值：HR=2.01；95%CI，1.03-3.92；P=0.04；NK细胞百分比：HR=0.88；95%CI，0.82-0.95；P=0.002。这些发现表明，淋巴细胞计数、中性粒细胞计数、CD4+/CD8+T细胞比值和NK细胞百分比均与PQ中毒病例的死亡率相关。
