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目的:探讨Presepsin与急性有机磷中毒(AOPP)患者病情严重程度与预后的关系。比较Presepsin和胆碱酯酶、肝肾功能等各项参数,结合临床表现来评估Presepsin的应用价值。方法:回顾性分析97例AOPP患者(病例组)的临床资料,根据患者入院时初始血Presepsin水平分为Presepsin增高组(PH组,Presepsin>319.8pg/ml,75例)和Presepsin正常组(PL组,Presepsin≤319.8pg/ml,22例)。所有入选者分别于治疗前及治疗后24、72h抽肘静脉血,用化学发光酶联免疫法测定血清中Presepsin浓度。同时留取血标本在我院中心实验室测定血白细胞(WBC)、肝肾功能、胆碱酯酶、白介素-18(IL-18),记录患者症状、体征以做对比。另选取我院健康体检合格者共20例做为对照组。比较病例组与对照组血清Presepsin浓度,并比较PH组和PL组治疗前及治疗后24、72h血清Presepsin水平变化与患者症状、体征、肝肾功能、APACHEⅡ等的相关性。结果:Presepsin检测结果显示,与健康个体的Presepsin浓度相比,AOPP患者Presepsin浓度明显升高,并且伴随分级的严重程度增高而增高。在存活者与死亡者(30d内死亡)之间,轻度AOPP和中重度AOPP之间,Presepsin水平差异有统计学意义(P<0.01),这均优于WBC、IL-18、肝肾功能等的检测,较胆碱酯酶更好地反映中毒严重程度,不逊于APACHEⅡ的临床评分。结论:血清Presepsin水平监测对于AOPP患者病情严重程度的评估、治疗和判断预后有一定的指导意义。
Objective: To investigate the relationship between the severity and the prognosis of patients with Presepsin and acute organophosphate poisoning (AOPP). Compare Presepsin and cholinesterase, liver and kidney function and other parameters, combined with clinical manifestations to evaluate the value of Presepsin. Methods: The clinical data of 97 AOPP patients (case group) were retrospectively analyzed. According to the Presepsin level at admission, the patients were divided into two groups: Presepsin increased group (PH group, Presepsin> 319.8pg / ml, 75 cases) and Presepsin normal group Group, Presepsin≤319.8 pg / ml, 22 cases). All the participants were given elbow venous blood 24 and 72 hours before treatment and after treatment respectively, and the serum Presepsin concentration was measured by chemiluminescence enzyme-linked immunosorbent assay. At the same time, blood samples were taken for determination of white blood cells (WBC), liver and kidney function, cholinesterase and interleukin-18 (IL-18) in the central laboratory of our hospital. The symptoms and signs of the patients were recorded for comparison. Another selected health examination in our hospital a total of 20 cases as a control group. Presepsin concentrations were compared between the two groups. The changes of serum Presepsin levels in PH group and PL group before and 24 and 72 hours after treatment were compared with those of the patients with symptoms, signs, liver and kidney function, APACHEⅡ and so on. Results: The results of Presepsin test showed that compared with Presepsin concentrations in healthy individuals, Presepsin concentrations in AOPP patients were significantly increased and increased with the severity of grading. There was a significant difference in Presepsin levels between mild and severe AOPP between survivors and deaths (within 30d) (P <0.01), which were better than those of WBC, IL-18, liver and kidney function And other tests, better reflect the severity of poisoning than cholinesterase, no less favorable than the APACHE Ⅱ clinical score. Conclusion: The serum Presepsin level monitoring has certain guiding significance for the assessment of the severity of AOPP patients, treatment and prognosis.