【摘要】 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。更多还原

【Abstract】 Objective To observe the application value of serum creatine kinase(CK) in predicting the prognosis of acute carbon monoxide poisoning(ACOP). Methods A total of 48 ACOP patients were divided by different degrees of intoxication into mild poisoning group(23 cases), moderate poisoning group(14 cases) and severe poisoning group(9 cases). Serum CK value was compared in three groups. They were also divided by different serum CK value into CK normal group(33 cases), CK mildly elevated group(7 cases) and CK severe elevated group(8 cases). Incidence of adverse prognosis events was observed in three groups. Results The severe poisoning groups had higher CK value than mild and moderate poisoning groups, and the mild poisoning group had higher CK value than mild poisoning group. Their difference had statistical significance(P<0.05). The more severe the degree of carbon monoxide poisoning, the higher the serum CK value of patients. Serum CK value is positively correlated to the prognosis of ACOP(r=0.71, P<0.05). It had sensitivity as 100.00% in predicting adverse prognosis events of ACOP, specificity as 73.33%, positive predictive value as 73.33%, negative predictive value as 100.00% and Yuden index as 0.92. CK normal group, CK mildly elevated group and CK severe elevated group had incidence of adverse ACOP events respectively as 0, 42.86% and 100.00%, and their difference had statistical significance(P<0.05). Conclusion Serum CK value can be used as a reliable index to predict the incidence of adverse events of ACOP, and it has good sensitivity. So it is worthy of clinical reference.更多还原