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目的探讨急性百草枯(PQ)中毒患者胸部CT检查及血浆PCT水平动态监测的临床意义。方法将84例急性PQ中毒患者根据中毒严重程度分为轻度组(28例)、中-重度组(34例)及暴发组(22例),选择同期健康体检者30例作为对照组。于中毒后第1 d、3 d、5 d、7 d及后期(第8 d~14 d)分别对各组患者进行常规胸部CT检查和血浆PCT水平检测。结果对照组胸部CT无异常影像表现,PQ中毒患者早期胸部CT影像表现明显异常。PQ中毒患者的血浆PCT水平明显高于对照组;轻度组患者中毒后第3 d~7 d的血浆PCT水平明显高于第1 d和后期;中-重度组和暴发组患者血浆PCT水平均随中毒后时间延长而逐渐升高,且均显著高于轻度组。死亡组早期胸部CT表现总得分和血浆PCT水平均明显高于存活组。PQ中毒患者中,高PCT水平组早期胸部CT表现总得分明显高于低水平组和正常水平组,以上差异均有统计学意义(P<0.05)。结论 PQ中毒患者胸部CT影像检查和血浆PCT水平监测对评估中毒的严重程度及预后具有重要意义。
Objective To investigate the clinical significance of chest CT examination and plasma PCT level dynamic monitoring in patients with acute paraquat (PQ) poisoning. Methods Eighty-four patients with acute PQ poisoning were divided into mild group (n = 28), moderate-severe group (n = 34) and outbreak group (n = 22) according to the severity of poisoning. The routine chest CT examination and plasma PCT level were performed on the 1st, 3rd, 5th, 7th and the later (8th to 14th day) after poisoning. Results There were no abnormal CT images in the control group and the abnormal chest CT images in the patients with PQ poisoning. The plasma PCT level in patients with PQ poisoning was significantly higher than that in the control group. The plasma PCT levels in the mild group were significantly higher than those in the first and the third day after the third day to the seventh day after poisoning. The PCT levels in both the moderate-severe group and the outbreak group With the extension of time after poisoning increased, and were significantly higher than the mild group. The total score of chest CT and plasma PCT in the early death group were significantly higher than those in the survival group. Among the patients with PQ poisoning, the total score of early chest CT in the high PCT group was significantly higher than that in the low and normal levels (P <0.05). Conclusion CT chest CT examination and plasma PCT level monitoring in patients with PQ poisoning are of great significance in assessing the severity and prognosis of poisoning.