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单核细胞淋巴细胞比值与急性百草枯中毒患者预后的相关性
引用本文:刘日升,曹春水. 单核细胞淋巴细胞比值与急性百草枯中毒患者预后的相关性[J]. 中华急诊医学杂志, 2021, 30(4): 467-472. DOI: 10.3760/cma.j.issn.1671-0282.2021.04.017
作者姓名:刘日升  曹春水
作者单位:南昌大学第一附属医院急诊科,330006
摘    要:目的:本研究旨在探讨血清中单核细胞淋巴细胞比值(monocytes to lymphocyte ratio, MLR)与急性百草枯(paraquat,PQ)中毒患者全因死亡之间的关系。方法:本研究回顾性选取2013年12月至2018年10月收治于南昌大学第一附属医院的急性PQ中毒患者,随访至2019年7月1日。主要终点...

关 键 词:单核细胞淋巴细胞比值(MLR)  百草枯  中毒  预后

The relationship between monocyte-to-lymphocyte ratio and prognosis in patients with acute paraquat poisoning.
Liu Risheng,Cao Chunshui. The relationship between monocyte-to-lymphocyte ratio and prognosis in patients with acute paraquat poisoning.[J]. Chinese Journal of Emergency Medicine, 2021, 30(4): 467-472. DOI: 10.3760/cma.j.issn.1671-0282.2021.04.017
Authors:Liu Risheng  Cao Chunshui
Affiliation:(Department of Emergency Medicine,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)
Abstract:Objective:To investigate the relationship between monocyte-to-lymphocyte ratio (MLR) in serum and the all-cause mortality in patients with acute paraquat (PQ) poisoning.Methods:Patients with acute PQ poisoning in the First Affiliated Hospital of Nanchang University from December 2013 to October 2018 were retrospectively selected and followed up until July 1, 2019. The primary endpoint was all-cause mortality. Patients were classified into quartiles based on serum MLR and also dichotomized based on the optimal cutoff at a MLR of 0.61, determined from the receiver operating characteristic (ROC) curve analysis. The Kaplan-Meier curve was used for survival analysis. Multivariate Cox regression analysis was performed to identify risk factors, and ROC curve was applied to analyze the predictive efficacy of MLR in all-cause mortality of acute PQ patients.Results:Of the 117 patients included in the study, 49 (41.88%) patients were male and 68 (58.12%) were female with a mean age of 36.91±16.00 years. The total mortality was 59.8% (70/117). On the Kaplan-Meier analysis, patients in quartile 4 had worse prognosis than patients in quartiles 1, 2 and 3 (Log-rank=33.376, P<0.01), and patients with MLR≥0.61 had a significantly higher all-cause mortality than those with MLR<0.61 (Log-rank=26.451, P<0.01). Cox regression model analysis showed that MLR was an independent predictor of all-cause mortality on the quartile analysis (quartile 4 vs. quartile 1: hazard ratio 2.773, 95% confidence interval ( CI): 1.250 to 6.154, P=0.012). ROC curve showed that the optimal cut-off value of MLR was calculated to be at 0.61, the area under the curve (AUC) was 0.684 (95% CI: 0.591-0.767, P=0.0002), with a sensitivity of 47.14% and a specificity of 91.49%. Conclusions:High MLR was associated with mortality risk in patients with acute PQ poisoning, and MLR may be an effective predictor of all-cause mortality in this population.
Keywords:Monocyte-to-lymphocyte ratio  Paraquat  Poisoning  Prognosis
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