乳酸及降钙素原对一氧化碳中毒后迟发性脑病的预测价值

目的探讨检测血乳酸、降钙素原和联合检测对急性一氧化碳中毒后迟发性脑病(DEACMP)的预测价值。 方法随机抽取我院在急诊科收住院的ACMP患者70例，随访3个月，以其中发生DEACMP患者10例为DEACMP组，其余60例为非DEACMP组，随机抽取同期笔者医院40例健康体检者为对照组。对患者立即行动脉血Lac和血清PCT检测，并计算Lac和PCT诊断DEACMP的灵敏度、特异度。 结果DEACMP组血Lac和PCT检测值均明显高于非DEACMP和对照组，差异有统计学意义(采用秩和检验，P<0.05)；检测异常率亦明显高于非DEACMP组及对照组，差异有统计学意义(采用χ²检验，P<0.05)。Lac和PCT升高预测DEACMP的敏感度均为90.0% ，特异度分别为50.0%和65.0% ，准确性分别为55.7%和68.6%。联合检测时若其中1个指标为阳性时即预测DEACMP发病，则联合检测的敏感度为100.0%，特异度为41.7%，阳性预测值为21.7%，阴性预测值为100.0%，准确性为71.4%。 结论DEACMP患者早期动脉血Lac和PCT均明显升高，PCT诊断价值优于Lac，联合检测较单项指标检测对DEACMP发病预测价值更理想。

Predictive values of the detection of lactic acid of arterial blood and procalcitonin in delayed encephalopathy after acute carbon monoxide poisoning

ObjectiveTo explore the predictive value of detection of Lac of arterial blood and PCT or combined detection for delayed encephalopathy after acute carbon monoxide poisoning(DEACMP). MethodsWe collected randomly 70 patients with acute carbon monoxide poisoning (ACMP) who were received in hospital in our emergency department; all the patients were followed up for 3 months, 10 of the them presented with DEACMP enrolled in the DEACMP group, and the other 60 patients enrolled in the non DEACMP group. At the same time, 40 health examination personnel in the corresponding period were collected randomly as control group. All patients were tested Lac of arterial blood and PCT immediately when they were received in hospital. The sensitivity and specificity of Lac, PCT and combined detection of both for diagnosis of DEACMP were calculated. ResultsLac of arterial blood and PCT in the group of DEACMP were all higher at different levels than those in non DEACMP group and control group(rank sum test, P<0.05). The abnormal rates of the early detection of Lac and PCT were all higher significantly in DEACMP group than those in non DEACMP group, and the difference had statistical significance(chi-square test, P<0.05). The sensitivity about the elevation of Lac and PCT predicting DEACMP all was 90.0%, specificity was 50.0% and 65.0%, respectively; accuracy was 55.7% and 68.6%, respectively. If one item of combined detection was positive for predicting the occurrence of DEACMP, the sensitivity of combined detection was 100.0%, specificity was 41.7%, positive predictive value was 21.7%, negative predictive value was 100.0%, and accuracy was 71.4%. ConclusionEarly index of Lac of arterial blood and PCT all increase at different levels in patients of DEACMP. The combined detection has more ideal predictive value than single index detection for predicting the occurrence of DEACMP.