【摘要】 目的 比较三种基于血浆百草枯浓度的预测方法在评估急性百草枯中毒患者预后中的价值。方法 回顾性分析225例APP患者的年龄、服毒量、血浆百草枯浓度及中毒时间,通过Proudfoot生存曲线、Jones生存回归方程和百草枯中毒严重指数(SIPP)推断患者预后,并比较各种方法的预测价值。结果 死亡组的服毒量、百草枯浓度和年龄大于存活组(P<0.05),中毒时间差异无统计学意义(P>0.05),但只有百草枯浓度及中毒时间进入Logistic回归方程(P<0.05)。SIPP的受试者工作特征(ROC)曲线下面积为0.916(P<0.05)。中毒24 h内SIPP的特异度、阳性预测值和阳性似然比最高;中毒0~4 h和4~24 h敏感度、阴性预测值最高的分别为Jones生存回归方程的和Proudfoot生存曲线。结论 SIPP对预测死亡的价值最高,Jones生存回归方程和Proudfoot生存曲线的优势分别在于预测中毒0~4 h和4~24 h患者存活。更多还原

【Abstract】 Objective To compare the prognostic value of three prediction methods which are based on palsma paraquat concentration in evaluation of acute paraquat poisoning(APP).Methods We retrospectively reviewed the age,ingestion amount,palsma paraquat concentration and time from poisoning to admission of 225 APP patients.Three methods were used to predict the prognosis of APP and their prognostic value were compared.The methods were Proudfoot survival curve,Jones regression equation and Severity Index of Paraqaut Poisoning(SIPP).Results The age,ingestion amount and plasma paraquat concentration in the deaths were higher than that in the survivals(P < 0.05),and there was no difference between time from poisoning to admission of the two groups(P < 0.05).The plasma paraquat concentration and time from poisoning to admission were correlated with prognosis by logistic regression analysis(P<0.05).The area under the Receiver Operating Characteristic(ROC) curve of SIPP was 0.916(P <0.05).For time from poisoning to admission < 24 hours,SIPP had the highest specificity,positive predictive value and positive likelihood ratio.The Jones regression equation and Proudfoot survival curve had the highest sensitivity and negative predictive value for 0-4 hours and 424 hours,respectively.Conclusion SIPP is the best method in predicting death,while the Jones regression equation and Proudfoot survival curve have advantage of predicting survival when time from poisoning to admission is 0-4 hours and 4-24 hours,respectively.更多还原