帕拉克瓦特中毒的肝损伤:一个回顾性队列研究
Yan Zhang1, Linlin Hou1, Ding Yuan1
1Department of Emergency Medicine, Medical Key Laboratory of Poisoning Diseases of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
概括
帕拉克瓦特 (PQ) 中毒可能导致肝损伤,从而增加死亡风险. 早期的肝损伤,特别是肝细胞损伤,是PQ中毒患者死亡的重要预测因素.
科学领域:
- 毒理学 毒理学 毒理学
- 临床医学 临床医学
- 预测研究 预测研究
背景情况:
- 帕拉克瓦特 (PQ) 中毒是全球死亡的一个重要原因.
- 肝损伤是PQ中毒的常见并发症,但其预后价值仍在争论中.
- 了解PQ中毒死亡率的风险因素对于临床管理至关重要.
研究的目的:
- 调查肝损伤是否是帕拉克瓦特中毒患者死亡的危险因素.
- 为了确定帕拉克瓦特暴露后肝损伤的特征和预后影响.
- 确定与PQ中毒死亡率相关的特定临床和生化标志物.
主要方法:
- 在640名被石毒害患者 (2011-2020年) 的回顾性队列研究中.
- 患者被分为正常肝功能和肝损伤组.
- 倾向性得分匹配 (PSM) 分析用于控制混因素,包括PQ剂量和入院时间.
主要成果:
- 肝损伤组年龄较大,与正常肝功能组相比,死亡率更高.
- 倾向性得分匹配包括240名患者,平衡关键变量.
- 虽然肝功能测试 (ALT,ALP, bilirubin) 与死亡率没有直接关联,但年龄,PQ剂量,肌酸酶,白细胞计数和分白细胞计数是显著的预测因素.
结论:
- 帕奎特中毒后48小时内发生的肝损伤是死亡的重要风险因素.
- 观察到的肝损伤主要是肝细胞性质的.
- 年龄,PQ剂量,肌酸激酶异酶和白细胞计数与死亡率呈正相关,而肌酸激酶,中性粒细胞和淋巴细胞百分比呈反相关.
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