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目的:探讨急性百草枯中毒(APP)患者外周血白细胞(WBC)计数对于早期评估预后的价值。方法:回顾性分析202例中毒24h内APP患者入院时的一般资料、外周血WBC计数和血浆百草枯(PQ)浓度。计算PQ中毒严重指数(SIPP),根据SIPP将患者分为3组[A组:SIPP<10(h·mg·L~(-1));B组:10(h·mg·L~(-1))≤SIPP≤50(h·mg·L~(-1));C组:SIPP>50(h·mg·L~(-1))],比较各组间WBC计数及60d病死率,并分析WBC计数与SIPP的相关性,比较二者评估预后的价值。结果:死亡患者就诊时WBC计数高于存活患者[(20.31±9.84)×10~9/L vs.(11.08±4.98)×10~9/L,P<0.05],SIPP水平越高组WBC计数越高(P<0.05),WBC和SIPP具有相关性(r=0.323,P<0.05),WBC和SIPP预测死亡的ROC曲线下面积分别为0.801和0.948(P<0.05),WBC截断值为14.37×10~9/L时预测死亡的敏感度和特异度分别为70.30%和80.20%,SIPP截断值为7.61(h·mg·L~(-1))时预测死亡的敏感度和特异度分别为91.09%和88.12%。结论:外周血WBC计数对于早期评估APP预后具有一定的临床价值,但需结合其他指标(如乳酸)综合判断。
Objective: To investigate the value of peripheral white blood cell (WBC) counts in patients with acute paraquat poisoning (APP) for early assessment of prognosis. Methods: We retrospectively analyzed the general data of admission, peripheral blood WBC count and plasma paraquat concentration (PQ) in 202 patients with APP poisoning within 24h. The PQ poisoning severity index (SIPP) was calculated and divided into three groups according to SIPP [group A: SIPP <10 (h · mg · L -1); group B: 10 (h · mg · L -1 1)) ≤SIPP≤50 (h · mg · L -1); group C: SIPP> 50 (h · mg · L -1)]. The WBC counts and the 60-day mortality , And analyzed the correlation between WBC count and SIPP, and compared the value of the two in assessing the prognosis. Results: The WBC count was significantly higher in survivors than in survivals [(20.31 ± 9.84) × 10 ~ 9 / L vs. (11.08 ± 4.98) × 10 ~ 9 / L, P <0.05] The correlation between WBC and SIPP was significant (r = 0.323, P <0.05). The area under the ROC curve predicted by WBC and SIPP was 0.801 and 0.948 respectively (P <0.05), and the cut-off value of WBC was 14.37 Sensitivity and specificity of prediction of death at the time of 10 ~ 9 / L were 70.30% and 80.20% respectively, and SIPP cutoff was 7.61 (h · mg · L -1) 91.09% and 88.12%. Conclusion: WBC counts in peripheral blood have some clinical value for early assessment of the prognosis of APP, but need to be combined with other indicators (such as lactic acid) comprehensive judgment.