目的 探讨血清中涎液化糖链抗原(KL-6)不同时间点表达水平对急性百草枯中毒患者28 d死亡的预测价值。方法 选取2015-12至2021-12联勤保障部队第960医院收治的急性百草枯中毒患者72例,分别测定患者入院时、入院后6 h和24 h血清KL-6、动脉血气和生化指标。分析3个时间节点血清学指标之间的相关性;应用logistics回归分析其预后的影响因素;绘制入院时、入院后6 h和24 h血清KL-6的ROC曲线,比较曲线下面积(AUC)。结果 患者中毒剂量[存活组(58.5±13.2)mg/kg vs 死亡组(155.9±20.5) mg/kg]和尿百草枯浓度[存活组(34.7±40.1)μg/mL vs 死亡组(343.6±300.9)μg/mL)]均与死亡呈显著相关(P＜0.05)。入院6 h(887.0±39.7 U/mL vs 1034.2±33.1 U/mL)和24 h(1223.0±74.4 U/mL vs 1945.3±80.7 U/mL)血清KL-6对急性百草枯中毒患者28 d死亡有预测价值,入院后24 h血清KL-6预测28 d死亡的AUC大于入院后6 h的(0.912 vs 0.700,P＜0.05)。结论 入院后6 h和24 h血清KL-6对急性百草枯中毒患者28 d死亡均有预测价值,且入院后24 h血清KL-6的预测能力最佳。
Abstract
Objective To investigate the value of the expression levels of KL-6 in serum at different time points in the evaluation of 28-day death in patients with acute paraquat poisoning. Methods Seventy-two patients with acute paraquat poisoning admitted to the 960th Hospital of PLA Joint Logistics Support Force from December 2015 to December 2021 were selected. The expression of KL-6 at admission, KL-6(6h), KL-6(24h) in serum, arterial blood gas and biochemical indexes were measured. The correlation between serological indexes of 3 time nodes was analyzed. The influencing factors that affected the outcome were analyzed by logistics regression analysis. The work characteristic curves (ROC curves) of KL-6 at admission, KL-6(6h), KL-6(24 h) in serum were drawn and the area under the curve (AUC) was compared. Results Toxic dose of patients [survival group (58.5±13.2) mg/kg vs death group (155.9±20.5) mg/kg)] and urinary paraquat concentration [survival group ( 34.7±40.1) μg/mL vs death group (343.6±300.9)μg/mL ]were significantly associated with death (P<0.05). Serum KL-6 at 6 h after admission (887.0±39.7 vs 1034.2±33.1 U/mL) and 24 h (1223.0±74.4 vs 1945.3±80.7 U/mL) had predictive value on 28 d death in patients with acute paraquat poisoning. The AUC of serum KL-6 at 24 h after admission was greater than that at 6 h after admission (0.912 vs 0.700, P<0.05). Conclusions The expression of KL-6(6h) and KL-6(24h) in serum is helpful in the early prediction of 28-day death in patients with acute paraquat poisoning, and the predictive ability of serum KL-6 at 24 h after admission is the best.
关键词
涎液化糖链抗原 /
百草枯 /
预后
Key words
KL-6 /
paraquat /
prognosis
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基金
国家自然科学基金青年科学基金项目(81600051)
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