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目的探讨百草枯中毒患者入院时血清缺氧诱导因子(HIF)-1α与百草枯血药浓度的相关性。方法回顾性分析2011年1月—2013年1月期间因口服百草枯中毒急诊科诊治的12例患者的临床资料。根据患者预后分为死亡组和存活组,对比分析两组患者入院时血白细胞计数、动脉血气分析以及肝肾功能等各项检查结果,应用高效液相色谱(HPLC)检测百草枯血药浓度,所用患者均行肺部CT检查,血清HIF-1α测定采用酶联免疫吸附法(ELISA)测定。结果死亡组患者白细胞计数、谷草转氨酶以及血肌酐明显高于存活组(P<0.05),动脉二氧化碳分压(PCO2)下降明显:中毒早期,肺部CT表现为渗出性病变,可见片状絮状影、磨玻璃样影及肺叶实变等。存活组与死亡组百草枯血药浓度分别为(12.17±4.89)和(89.35±17.48)mg/L,差异具有统计学意义(P<0.05);血清HIF-1α水平分别为(58.99±14.02)和(161.42±28.2)ng/ml,差异具有统计学意义(P<0.05)。相关性分析显示,百草枯血药的浓度与HIF-1α水平呈显著正相关性(r=0.907,P<0.01)。结论百草枯中毒患者入院时血清中HIF-1α水平可能是百草枯中毒患者预后的一项有效评估指标。
Objective To investigate the correlation between serum hypoxia inducible factor (HIF) -1α and paraquat concentration in patients with paraquat poisoning. Methods The clinical data of 12 patients diagnosed by oral paraquat poisoning during the period from January 2011 to January 2013 were retrospectively analyzed. According to the prognosis of patients, the patients were divided into death group and survival group. The blood leukocyte counts, arterial blood gas analysis and liver and kidney function were compared between the two groups. The results of paraquat plasma concentrations were determined by high performance liquid chromatography (HPLC) All patients underwent lung CT examination, serum HIF-1α was measured by enzyme-linked immunosorbent assay (ELISA). Results The white blood cell count, aspartate aminotransferase and serum creatinine in the death group were significantly higher than those in the survival group (P <0.05). The arterial carbon dioxide partial pressure (PCO2) decreased significantly. In the early stage of poisoning, lung CT showed exudative lesions, Shadow, ground glass-like shadow and consolidation of the lungs. The plasma concentrations of paraquat in the surviving group and the dead group were (12.17 ± 4.89) and (89.35 ± 17.48) mg / L, respectively, with statistical significance (P <0.05). The serum HIF-1α levels were (58.99 ± 14.02) And (161.42 ± 28.2) ng / ml, the difference was statistically significant (P <0.05). Correlation analysis showed that there was a significant positive correlation between the concentration of paraquat and HIF-1α (r = 0.907, P <0.01). Conclusion The level of HIF-1α in serum of patients with paraquat poisoning on admission may be an effective evaluation index for the prognosis of paraquat poisoning patients.