Abnormal pancreatic enzymes and their prognostic role after acute paraquat poisoning.
Abnormal pancreatic enzymes and their prognostic role after acute paraquat poisoning.
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DOI：
10.1038/srep17299
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发表时间：
2015-11-25
影响因子：
4.6
通讯作者：
Yu X
中科院分区：
文献类型：
--
作者：
Li Y;Wang M;Gao Y;Yang W;Xu Q;Eddleston M;Li L;Yu X
摄入百草枯会导致多器官衰竭。预后最好通过测量血液中百草枯浓度来估计，但大多数医院没有这种设施。我们研究了胰酶异常对生存的预后意义。招募急性百草枯中毒患者。一系列广泛的血液检查包括血清淀粉酶被连续检查。根据血清淀粉酶活性（正常[<220 U/L]、轻度升高[220 ~ 660 U/L]、升高[>660 U/L]）对患者进行分类，并比较两组患者的生存率。177名患者参加了这项研究，其中67人死亡，110人幸存。正常组122例（70.62%），轻度升高组27例（15.25%），升高组25例（14.13%）。升高组病死率为100%，正常组为17% （P < 0.001）。我们发现了预测百草枯死亡的四个独立因素：淀粉酶、PaCO2、白细胞数量和中性粒细胞百分比。胰酶活性模型具有较好的预测能力。我们发现胰腺酶异常是急性百草枯中毒后死亡的有效预后指标。将血清淀粉酶活性纳入预后模型提供了良好的预测。
Ingestion of paraquat causes multi-organ failure. Prognosis is best estimated through measurement of blood paraquat concentrations but this facility is not available in most hospitals. We studied the prognostic significance of abnormal pancreatic enzymes for survival. Patients with acute paraquat poisoning were recruited. An extensive series of blood tests including serum amylase were serially checked. Patients were sorted according to their serum amylase activity (normal [<220 U/L], mildly elevated [220 to 660 U/L], elevated [>660 U/L]), and survival compared between groups. 177 patients were enrolled to the study, of whom 67 died and 110 survived. 122 (70.62%), 27 (15.25%) and 25 (14.13%) patients were in the normal, mildly elevated and elevated amylase activity groups, respectively. The case fatality in the elevated group was 100% compared to 17% in the normal group (P < 0.001). We found four independent factors for paraquat death prediction: amylase, PaCO2, leukocyte number, and neutrophil percentage. Models using pancreatic enzyme activity showed good prediction power. We have found that abnormal pancreatic enzymes are useful prognostic marker of death after acute paraquat poisoning. Including serum amylase activity into a prognostic model provides a good prognostication.