急性有机磷农药中毒患者预后相关因素分析

目的：调查急性有机磷农药中毒（AOPP）患者可能存在预后相关的危险因素，并分析其与预后的关系。方法选择急性有机磷农药中毒患者71例，收集患者临床资料，并将患者分为存活组和死亡组，先以单因素分析筛选出有统计学意义的危险因素，再通过前进法多元逐步 logistic 回归分析确定 AOPP预后的独立危险因素，并作ROC曲线分析危险因素对AOPP预后的评估价值。结果 logistic回归分析显示入院6h血乳酸水平、6h乳酸清除率、血酸碱度3个变量是急性有机农药磷中毒预后的影响因素。从OR值来看，入院6h血乳酸升高是危险因素，6h乳酸清除率高、血酸碱度高是保护因素。以6h乳酸清除率评估急性有机农药磷中毒预后的ROC曲线下面积为0.85，当6h乳酸清除率为5.99%时，约登指数最大。结论6h乳酸清除率可应用于急性有机磷农药中毒预后的评估。

Analysis of influencing factors of acute organophosphorus pesticide poisoning

Objective To investigate the risk factors of acute organophosphorus pesticide poisoning（AOPP） and analyze the relationship between risk factors and AOPP. Methods The clinical data of the 71 cases of acute organophosphorus pesticide poisoning which divided into survival group and death group were collected. The risk factors were screened out with univariate analysis and multivariate stepwise logistic regression analysis. Results The logistic regression analysis showed artery lactate level at 6 hours after admission,artery lactate clearance rate at 6 hours and blood Ph were influencing factors of AOPP. Artery lactate level at 6 hours after admission was risk factor while the artery lactate clearance rate at 6 hours and blood Ph were were protective factors according OR values. The ROC curve area of using value of artery lactate clear-ance at 6 hours to evaluate prognosis of AOPP was 0.85. When the artery lactate clearance rate at 6 hours was 5.99%, the Youden index was largest. Conclusion Artery lactate clearance rate at 6 hours can be used to evaluate the prognosis of AOPP.