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目的观察血清肌酸激酶(CK)在预测急性一氧化碳中毒(ACOP)预后的应用价值。方法 48例ACOP患者,按照中毒程度不同分为轻度中毒组(25例)、中度中毒组(14例)和重度中毒组(9例)。比较三组患者血清CK值;另按照患者血清CK值不同分为CK正常组(33例)、CK轻度升高组(7例)、CK重度升高组(8例),观察三组患者预后不良事件发生率。结果重度中毒组患者CK值高于轻度中毒组、中度中毒组患者,中度中毒组患者CK值高于轻度中毒组患者,差异均具有统计学意义(P<0.05),一氧化碳中毒程度越重,患者血清CK值越高。血清CK值与ACOP预后存在正相关(r=0.71,P<0.05);其预测ACOP预后不良事件的敏感性为100.00%,特异性为73.33%,阳性预测值为73.33%,阴性预测值为100.00%,尤登指数为0.92。CK正常组、CK轻度升高组、CK重度升高组患者ACOP不良事件发生率分别为0、42.86%、100.00%,组间比较差异具有统计学意义(P<0.05)。结论血清CK值可以作为预测ACOP预后不良事件发生率的可靠指标,敏感性好,值得临床借鉴。
Objective To observe the value of serum creatine kinase (CK) in predicting the prognosis of acute carbon monoxide poisoning (ACOP). Methods 48 cases of ACOP patients were divided into mild poisoning group (25 cases), moderate poisoning group (14 cases) and severe poisoning group (9 cases) according to the degree of poisoning. The serum CK was compared between the three groups. According to the serum CK, the patients were divided into CK normal group (33 cases), CK mildly elevated group (7 cases) and CK severe hypergroup (8 cases) Prognosis of adverse events. Results The CK value of severe poisoning group was higher than that of mild poisoning group and moderate poisoning group. The CK value of moderate poisoning group was higher than that of mild poisoning group (P <0.05), the degree of carbon monoxide poisoning The heavier, the higher the serum CK value of patients. There was a positive correlation between serum CK and ACOP prognosis (r = 0.71, P <0.05). The predictive value of ACOP prognostic adverse event was 100.00%, specificity was 73.33%, positive predictive value was 73.33%, negative predictive value was 100.00 %, Youden index is 0.92. The incidence of adverse events of ACOP in CK normal group, mild CK group and severe CK group were 0, 42.86% and 100.00%, respectively. The difference between the two groups was statistically significant (P <0.05). Conclusions Serum CK value can be used as a reliable index to predict the incidence of adverse events after ACOP. It has good sensitivity and worthy of clinical reference.