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目的探讨急性有机磷中毒(AOPP)患者血浆P-选择素、简化急性生理学评分系统(SAPSⅡ)变化及二者间关系。方法正常组30例,测定其空腹P-选择素;AOPP组28例,测定入院时血浆P-选择素,计算SAPSⅡ评分及预期死亡率(PDR)。比较两组P-选择素值;比较中毒患者中死亡组和存活组的SAPSⅡ评分及PDR;采用多元线性回归分析,评估P-选择素等因素与SAPSⅡ评分及PDR的关系。结果中毒组血浆P-选择素显著高于对照组(P=0·002)。死亡组SAPSⅡ评分及PDR显著高于存活组(P<0·001);P-选择素与SAPSⅡ评分、PDR呈明显正相关(r=0·487,P<0·01;r=0·424,P<0·025)。结论SAPSⅡ能准确判断AOPP患者病情并预测死亡率。AOPP患者血浆P-选择素明显升高,与SAPSⅡ评分及PDR呈明显正相关,是SAPSⅡ评分的独立预测因子。
Objective To investigate the changes of plasma P-selectin and the simplified acute physiology scoring system (SAPSⅡ) in patients with acute organophosphorus poisoning (AOPP) and their relationship. Methods Thirty normal subjects were selected and their fasting P-selectin was measured. In the AOPP group, 28 patients were selected. The plasma P-selectin level at admission, SAPSⅡ score and expected mortality (PDR) were calculated. The P-selectin values of two groups were compared. The SAPSⅡscore and PDR of the dead and survivor groups were compared. The multivariate linear regression analysis was used to evaluate the relationship between P-selectin and SAPSⅡscore and PDR. Results Plasma P-selectin in the poisoning group was significantly higher than that in the control group (P = 0.002). The SAPSⅡscore and PDR in the death group were significantly higher than those in the surviving group (P <0.001); P-selectin was positively correlated with SAPSⅡscore and PDR (r = 0.487, P <0.01; r = 0.244 , P <0 · 025). Conclusion SAPS Ⅱ can accurately judge the condition of AOPP patients and predict the mortality rate. Plasma P-selectin was significantly elevated in patients with AOPP, which was positively correlated with SAPSⅡscore and PDR, and was an independent predictor of SAPSⅡscore.