论文部分内容阅读
目的探讨百草枯(PQ)中毒24小时内肺CT磨玻璃影(GGO)体积及其早期动态变化与预后的关系。方法回顾性分析58例PQ中毒患者24小时内CT影像学表现,其中,42例有中毒后2天、4天及7天完整的CT随访资料,根据PQ中毒90天内患者的生存情况分为生存组和死亡组,比较两组临床指标、GGO体积及动态变化特点,对具显著差异的客观指标采用Logistic回归分析,寻找有独立预后效应的因子,然后进一步采用ROC曲线分析其预测死亡的效能。采用Kaplan-Meier生存曲线分析GGO组和无GGO组的存活率。结果生存组33例,死亡组25例,GGO体积、血肌酐、PaO_2具有独立预后价值,死亡组24小时内GGO体积显著大于生存组(P<0.05)。其预测死亡的敏感性、特异性和准确性分别为96.97%、68%、74%;GGO体积曲线下面积(AUC=0.837)大于血肌酐(AUC=0.832)、PaO_2(AUC=0.739)。GGO组存活率为32.1%,无GGO组则高达80%(P<0.05)。生存组GGO体积一周内复查无差异,死亡组则明显升高。结论 PQ中毒24小时内GGO有无、体积大小及其早期动态变化对于判断PQ中毒预后具有客观的临床指导价值。
Objective To investigate the relationship between volume and early dynamic changes of pulmonary gravimetric glass (GGO) volume and prognosis in paraquat (PQ) poisoning within 24 hours. Methods A retrospective analysis of 58 cases of PQ poisoning within 24 hours of CT imaging performance, of which 42 cases after poisoning 2 days, 4 days and 7 days complete CT follow-up data, according to the survival of patients within 90 days of PQ poisoning is divided into survival Group and death group. Logistic regression analysis was used to compare the clinical indexes, GGO volume and dynamic changes between the two groups. Logistic regression analysis was used to find the factors that had independent prognostic effect. Then the ROC curve was used to analyze the predictive value of death. Kaplan-Meier survival curves were used to analyze the survival rate of GGO group and no GGO group. Results 33 cases of survival group, 25 cases of death group, GGO volume, serum creatinine, PaO_2 with independent prognostic value, within 24 hours of death group GGO volume was significantly greater than the survival group (P <0.05). The sensitivity, specificity and accuracy of predicting death were 96.97%, 68% and 74%, respectively. The area under the volume curve of GGO (AUC = 0.837) was higher than serum creatinine (AUC = 0.832) and PaO_2 (AUC = 0.739). The survival rate was 32.1% in the GGO group and 80% in the GGO group (P <0.05). Survival group GGO volume no difference within a week review, the death group was significantly higher. Conclusion The presence or absence of GGO within 24 hours after PQ poisoning, volume and its early dynamic changes have an objective clinical value in judging the prognosis of PQ poisoning.