Predictors of survival after acute paraquat poisoning
Predictors of survival after acute paraquat poisoning
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DOI：
10.1191/0748233702th141oa
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发表时间：
2002-01-01
影响因子：
1.9
通讯作者：
Hong, SY
中科院分区：
文献类型：
--
作者：
Lee, EY;Kwang, KY;Hong, SY
急性百草枯中毒往往是致命的。许多研究已经调查了成功的治疗方式，但还没有标准的治疗方法。本研究的目的是确定602例急性百草枯中毒患者的生存预测因素。百草枯暴露量是根据摄入的百草枯量和尿液中百草枯含量的半定量测量值进行评估的。在到达急诊室时获得初始临床参数，包括生命体征、血红蛋白、白细胞计数、pH、PaCO 2、PaO 2、血尿素氮、肌酐、天冬氨酸转氨酶、丙氨酸转氨酶、总胆红素、淀粉酶和葡萄糖。急性百草枯中毒后的结果分为幸存者和非幸存者。采用多元Logistic回归分析评估急性百草枯中毒后生存的预测因素，口服百草枯后部分患者（55.5%）存活，而经皮或吸入途径暴露于百草枯的患者全部存活。摄入百草枯（24.5%浓缩的1，1 '-二甲基-4，4'-联吡啶二氯化物）的量为45.69+/-74.1 mL（平均值+/-SD）。除百草枯暴露程度外，急性百草枯中毒后的存活率与年龄、呼吸频率、pH值、PaCO 2、血红蛋白、白细胞计数、血尿素氮、淀粉酶和多因素Logistic回归分析中衰竭器官的数量相关。总之，年轻、经皮或吸入途径、接触较少的百草枯、入院时白细胞增多、酸中毒和肾、肝、胰腺衰竭程度较轻是急性百草枯中毒后生存的良好预后因素。
Acute paraquat poisoning is often fatal. Many studies have investigated successful treatment modalities, but no standard treatment yet exists. The purpose of this study was to determine the predictors of survival after acute paraquat poisoning in 602 patients. The paraquat exposure was assessed based on the amount of ingested paraquat and a semiquantitative measure of the urine level of paraquat. Initial clinical parameters including vital signs, hemoglobin, white-blood-cell count, pH, PaCO2, PaO2, blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, total bilirubin, amylase, and glucose were obtained at the time of arrival at the emergency room. Outcomes after acute paraquat poisoning were categorized as survivors and nonsurvivors. Multiple logistic regression analysis was applied to assess the predictors of survival after acute paraquat poisoning.Some patients (55.5%) survived after oral ingestion of paraquat, whereas all those exposed to paraquat percutaneous or inhalational route survived. The amount of paraquat (24.5% concentrate of 1,1'-dimethyl-4,4'-bipyridium dichloride) ingested was 45.69+/-74.1 mL (mean+/-SD). In addition to degree of paraquat exposure, survival after acute paraquat poisoning was associated with age, respiratory rate, pH, PaCO2, hemoglobin, white-blood-cell count, blood urea nitrogen, amylase, and the number of failed organs in multiple logistic regression analysis. In conclusion, young age, percutaneous or inhalational route, exposure to less paraquat, and lesser degrees of leukocytosis, acidosis, and renal, hepatic, and pancreatic failures on admission are good prognostic factors of survival after acute paraquat poisoning.