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[目的]探讨急性百草枯中毒患者入院24 h内影响预后的危险因素.[方法]收集2009年1月至2013年8月本院急诊科收治的急性百草枯中毒患者123例,根据预后分为存活组(46例)和死亡组(77例).比较两组患者一般情况(性别、年龄、口服百草枯剂量、服毒至洗胃和灌流的时间、灌流次数)、入院时血百草枯浓度、入院后24 h内最差急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、血气分析、血常规、尿常规、肝肾功能、心肌酶谱、电解质等生化指标,并分析影响预后的危险因素.[结果]两组患者年龄比较差异均无统计学意义(P>0.05);存活组服毒量和入院时血百草枯浓度均明显低于死亡组(P0.05).死亡组白细胞计数、丙氨酸氨基转移酶(ALT)和肌酐(Cr)水平显著高于存活组(P<0.05);死亡组患者K+水平低于存活组(P0.05).死亡组患者pH、HCO3-、PaO2、PaCO2均低于存活组(P<0.05),死亡组患者乳酸水平和APACHEⅡ评分均明显高于存活组(P0.05).The survival dose and the concentration of paraquat in the surviving group were lower than those in the death group (P<0.05),but there was no significant difference between perfusion time and perfusion time.The levels of AST(Aspartate aminotransferase),Tbil(Serum total bilirubin),BUN(Urea nitrogen) and CK(Creatine kinase) in the survivors group and the death group were significantly higher than those in the survivors group (P0.05).The levels of pH,HCO3-,PaO2 and PaCO2 in the death group were lower than those in the survival group (P<0.05).The lactate level and APACHE Ⅱ score of the death group were higher than those of the survival group (P<0.05).Multivariate Logistic regression analysis showed that the concentration of blood paraquat,WBC,lactic acid,toxin,pH and K+ were the risk factors of acute paraquat poisoning.[Conclusion]The levels of blood paraquat,WBC,lactic acid,toxication,pH and K+ were the risk factors of early death in patients with acute paraquat poisoning,and with the high prognostic value.