急性百草枯中毒患者肝功能变化及意义

目的：探讨急性百草枯中毒（APP）患者肝功能变化与预后的关系。方法：APP患者46例，以住院期间临床死亡作为观察终点，分为存活组24例、死亡组22例。分别采集患者入院第1、3、7天空腹静脉血进行谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）、直接胆红素（DBIL）和白蛋白（ALB）检测，两组比较并进行统计学分析。结果：存活组入院第1天ALT、AST、DBIL、ALB，第3、7天ALT、AST、TBIL、DBIL明显低于死亡组（P〈0．05）；存活组入院第1、3、7天ALT逐渐升高（P〈0．05），ALB逐渐降低（P〈0．05），而AsT未见明显变化（P〉0．05）；死亡组入院第3天A1月、AST、TBIL、DBIL较入院第1天显著升高（P〈0．01），入院第3天ALB较第1天显著降低（P〈0．01）。结论：APP患者的肝功能指标变化与中毒程度有关，是判断APP病情严重程度，肝脏损伤情况及预后的可靠指标。

Change and clinical significance of liver function in patients with acute paraquat poisoning

Objective:To investigate the changes of the plasma levels of liver function and the relationship between these changes and the prognosis in patients with acute paraquat poisoning.Methods:46 patients were divided into two groups,the death group and the survival group,according to death in hospital.On the 1 st day,the 3 rd day and the 7 th day after poison,patients’venous blood were collected.ALT,AST,TBIL,DBIL and ALB were detected.The data were analyzed.Rusults:On the 1 st day after poison,ALT,AST,DBIL and ALB in the survival group were lower than the death group.On the 3 rd and 7 th day,ALT,AST,TBIL and DBIL in the survival group were also lower than those in the death group.ALT rose gradually and the ALB lowered gradually while AST had no obvious change in the survival group.On the 3 th day ALT,AST,TBIL and DBIL in the death group were higher than those in the 1 st day while ALB was lower than the 1 st day.Conclusion:The changes of liver function index might be the reliable indicators for the severity of paraquat poisoning,liver injury and the prognosis.