论文部分内容阅读
目的探讨外周血内肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的水平对急性百草枯中毒患者临床预后的预测价值。方法选取沧州市人民医院2009年8月至2015年6月诊治的急性百草枯中毒患者216例为研究组,同时根据生存情况分为生存组和死亡组;另选取同期体检的正常人的血液60例为对照组。采集患者年龄、性别、服毒至入院时间、中毒浓度计中毒剂量等指标,应用酶联免疫吸附测定法(ELISA)检测患者IL-6、TNF-α、24 h最差IL-6及TNF-α的水平,并应用受试者工作特征曲线(ROC)评估各指标对急性百草枯中毒的预后价值。结果与生存组相比,死亡组患者的服毒至入院时间显著增加,中毒浓度、中毒剂量、IL-6、TNF-α、24 h最差IL-6和TNF-α水平均显著升高,差异有统计学意义(P<0.05);与对照组相比,生存组患者的IL-6、TNF-α、24 h最差IL-6和TNF-α水平均显著升高,差异有统计学意义(P<0.05);ROC曲线结果显示,24 h最差IL-6最佳临界值为>42.27时,预测急性百草枯中毒患者死亡的特异性为67.46%,敏感性为73.33%,曲线下面积为0.75(0.69,0.82);24h最差TNF-α最佳临界值为>102.26时,预测急性百草枯中毒患者死亡的特异性为72.22%,敏感性为86.67%,曲线下面积为0.8660(0.82,0.91)。结论 24 h最差IL-6和TNF-α水平可作为预测急性百草枯中毒患者预后的重要参考指标。
Objective To investigate the predictive value of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels in patients with acute paraquat poisoning in clinical prognosis. Methods Totally 216 acute paraquat poisoning patients diagnosed and treated in Cangzhou People’s Hospital from August 2009 to June 2015 were selected as study group and divided into survival group and death group according to their survival condition. Example for the control group. The patients’ age, sex, time from poisoning to admission, poisoning dose of poisoning concentration meter and other indexes were collected. The levels of IL-6 and TNF-α, the worst IL-6 and TNF-α in 24 h were detected by enzyme linked immunosorbent assay (ELISA) The receiver operating characteristic curve (ROC) was used to assess the prognostic value of each index on acute paraquat poisoning. Results Compared with the survival group, the patients in the death group had a significant increase in the time from hospitalization to admission, and the concentrations of toxicant, toxic dose, IL-6 and TNF-α, the worst IL-6 and TNF-α levels at 24 h were significantly increased (P <0.05). Compared with the control group, the levels of IL-6 and TNF-α, the worst IL-6 and TNF-α in 24 h in the survival group were significantly increased, the difference was statistically significant (P <0.05). The ROC curve showed that the best cut-off value of IL-6 at 24 h was> 42.27, the specificity of mortality was 67.46% and the sensitivity was 73.33%. The area under the curve Was 0.75 (0.69,0.82). The best cutoff value of 24h worst TNF-α was> 102.26, the specificity of death in acute paraquat poisoning was 72.22%, the sensitivity was 86.67% and the area under the curve was 0.8660 (0.82 , 0.91). Conclusion The worst IL-6 and TNF-α levels at 24 h may be used as an important reference for predicting the prognosis of patients with acute paraquat poisoning.