急性百草枯中毒患者血清降钙素原水平的动态变化及意义

目的：观察急性百草枯中毒患者血清降钙素原（PCT）水平的变化,探讨其与预后的关系。方法：选取2013-09-2013-12我院急诊医学部收治的64例急性百草枯中毒患者,以入院期间为观察终点分为生存组和死亡组;根据PCT浓度分为正常组、低水平组、高水平组。测定患者入院后第1、3、7天的血清PCT,比较不同分组患者PCT浓度差异并分析PCT浓度变化与预后关系。结果：164例患者存活35例,死亡29例,存活率为54.7%。根据早期PCT浓度分为正常组、低水平组和高水平组,3组患者死亡率比较差异有统计学意义（P〈0.05）;2不同PCT浓度与MODS的发生率比较,高水平组MODS的发生率显著高于低水平组、正常组,差异有统计学意义（P〈0.05）;3PCT动态变化显示：死亡组第1、3、7天PCT水平显著高于生存组,第1天：（1.61±0.76）∶（0.06±0.02）,第3天：（2.13±1.32）∶（0.19±0.09）,第7天：（2.51±1.26）∶（0.12±0.08）,P〈0.05];生存组患者PCT于第3天左右达高峰后呈下降趋势,死亡组则呈逐步上升趋势。结论：PCT浓度升高可作为判断急性百草枯中毒患者中毒严重程度的指标;及时动态检测PCT,对了解中毒程度,预后评估及指导临床治疗有重要意义。

The dynamic change and clinical significance of procalcitonin in acute paraquat intoxication patients

Objective：To observe the dynamic change of procalcitonin （PCT） in patients with acute paraquat poisoning,and study the relationship between PCT and prognosis. Method： 64 patients with acute paraquat poison ing （oral poisoning ） received by Department of Emergency Medicine of the First Affiliated Hospital of Zhengzhou University were divided into death group and survival group. According to early PCT concentration, the 64 cases were divided into high level group,low level group and normal group. On the 1st day,the 3rd day and the 7th day after poisoning,blood PCT were detected. The relationship between the levels of PCT and the treatment success rate were analyzed. Result：（1）The survival rate was 54.7 % （35/64）. According to the early PCT concentration for the sector the 64 cases were divided into high level group, low level group and normal group. The death rate has differences among these three groups had marked statistical significance（P（0.05）. （2）The occurrence rate of mul tiple organ dysfunction syndrome （MODS） were significantly higher in high level group than that in low level group and normal group（P（0.05）. （3）Aceording to dynamic analysis：On the 1st day,the 3rd day and the 7th day after poisoning,the levels of PCT in death group were significantly higher than that in survival group1 d：l. 61± 0.7 vs. 0. 06±0. 02,3 d：2.13±1.30 vs. 0.19±0. 09,7 d：2. 51±1. 26 vs. 0.12±0.08,P〈0.05];There had been a gradually increasing trend in death group,but in survival group,it raised first on the 3rd day and then declined. Conclusion：The increased concentration of blood PCT in patients with paraquat poisoning can be used in evaluating poisoning degree. And through dynamic monitoring of PCT,it has rather vital value as clinical reference to learn poisoning degree,judge the prognosis and guide clinical treatment.