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中华卫生应急电子杂志 ›› 2022, Vol. 08 ›› Issue (05) : 272 -275. doi: 10.3877/cma.j.issn.2095-9133.2022.05.003

论著

乳酸及降钙素原对一氧化碳中毒后迟发性脑病的预测价值
陈士超1, 张艳敏1, 刘乃政1,(), 曲爱君1   
  1. 1. 252000 山东聊城,聊城市人民医院急诊科
  • 收稿日期:2022-06-30 出版日期:2022-10-18
  • 通信作者: 刘乃政

Predictive values of the detection of lactic acid of arterial blood and procalcitonin in delayed encephalopathy after acute carbon monoxide poisoning

Shichao Chen1, Yanmin Zhang1, Naizheng Lui1,(), Aijun Qu1   

  1. 1. Department of Emergency, Liaocheng People’s Hospital, Liaocheng 252000, China
  • Received:2022-06-30 Published:2022-10-18
  • Corresponding author: Naizheng Lui
引用本文:

陈士超, 张艳敏, 刘乃政, 曲爱君. 乳酸及降钙素原对一氧化碳中毒后迟发性脑病的预测价值[J/OL]. 中华卫生应急电子杂志, 2022, 08(05): 272-275.

Shichao Chen, Yanmin Zhang, Naizheng Lui, Aijun Qu. Predictive values of the detection of lactic acid of arterial blood and procalcitonin in delayed encephalopathy after acute carbon monoxide poisoning[J/OL]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2022, 08(05): 272-275.

目的

探讨检测血乳酸、降钙素原和联合检测对急性一氧化碳中毒后迟发性脑病(DEACMP)的预测价值。

方法

随机抽取我院在急诊科收住院的ACMP患者70例,随访3个月,以其中发生DEACMP患者10例为DEACMP组,其余60例为非DEACMP组,随机抽取同期笔者医院40例健康体检者为对照组。对患者立即行动脉血Lac和血清PCT检测,并计算Lac和PCT诊断DEACMP的灵敏度、特异度。

结果

DEACMP组血Lac和PCT检测值均明显高于非DEACMP和对照组,差异有统计学意义(采用秩和检验,P<0.05);检测异常率亦明显高于非DEACMP组及对照组,差异有统计学意义(采用χ2检验,P<0.05)。Lac和PCT升高预测DEACMP的敏感度均为90.0% ,特异度分别为50.0%和65.0% ,准确性分别为55.7%和68.6%。联合检测时若其中1个指标为阳性时即预测DEACMP发病,则联合检测的敏感度为100.0%,特异度为41.7%,阳性预测值为21.7%,阴性预测值为100.0%,准确性为71.4%。

结论

DEACMP患者早期动脉血Lac和PCT均明显升高,PCT诊断价值优于Lac,联合检测较单项指标检测对DEACMP发病预测价值更理想。

Objective

To explore the predictive value of detection of Lac of arterial blood and PCT or combined detection for delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).

Methods

We collected randomly 70 patients with acute carbon monoxide poisoning (ACMP) who were received in hospital in our emergency department; all the patients were followed up for 3 months, 10 of the them presented with DEACMP enrolled in the DEACMP group, and the other 60 patients enrolled in the non DEACMP group. At the same time, 40 health examination personnel in the corresponding period were collected randomly as control group. All patients were tested Lac of arterial blood and PCT immediately when they were received in hospital. The sensitivity and specificity of Lac, PCT and combined detection of both for diagnosis of DEACMP were calculated.

Results

Lac of arterial blood and PCT in the group of DEACMP were all higher at different levels than those in non DEACMP group and control group(rank sum test, P<0.05). The abnormal rates of the early detection of Lac and PCT were all higher significantly in DEACMP group than those in non DEACMP group, and the difference had statistical significance(chi-square test, P<0.05). The sensitivity about the elevation of Lac and PCT predicting DEACMP all was 90.0%, specificity was 50.0% and 65.0%, respectively; accuracy was 55.7% and 68.6%, respectively. If one item of combined detection was positive for predicting the occurrence of DEACMP, the sensitivity of combined detection was 100.0%, specificity was 41.7%, positive predictive value was 21.7%, negative predictive value was 100.0%, and accuracy was 71.4%.

Conclusion

Early index of Lac of arterial blood and PCT all increase at different levels in patients of DEACMP. The combined detection has more ideal predictive value than single index detection for predicting the occurrence of DEACMP.

1
中华人民共和国卫生部.GBZ23-2002职业性急性一氧化碳中毒诊断标准[S].北京:中国标准出版社,2002.
2
葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013: 907.
3
康新建,袁芳,赵军,等.一氧化碳中毒患者心率变异性的研究[J].实用心脑肺血管病杂志201119(8):1311.
4
葛晓霞.急性一氧化碳中毒后迟发性脑病临床治疗分析[J].中国现代药物应用20141(8):102-103.
5
Pepe GCastelli MNazerian P,et al.Delayed neuropsycho-logical sequelae after carbon monoxide poisoning:predictive risk factors in the emergency department. a retrospective study[J].Scand J Trauma Resusc Emerg Med2011(19):16.
6
李春盛.乳酸与危重病[J].急救医学19992(8):127-129.
7
王昊,吴大玮,陈晓梅,等.血乳酸水平及清除率和升高时间与重症监护病房患者预后的关系[J].中国危重病急救医学200921(6):357-360.
8
Moon JMShin MHChun BJ.The value of initial lactate in pa-tientswith carbonmonoxide intoxication:in the emergency department[J].Hum Exp Toxicol, 201130(8):836-843.
9
Inou S SaitoTTsuji T,et al.Lactate asa prognostic factorin carbonmonoxide poisoning: a case report[J].Am J EmergMed200826(8):966.
10
Assicot MGendrel DCarsin H,et al.High serum procalcitonin concentrations in patients with sepsis and infection[J].Lancet1993341(8844):515-518.
11
Nseir NAder F.Prevalence and outcome of severe chronic obstructive pulmonary disease exacerbations caused by multi drug-resistant bacteria[J].Curr Opin Pulm Med200814(2):95-100.
12
Sutherland AThomas MBrandon RA,et al.Development and validation of a novel molecular biomarker diagnosis test for the early detection of sepsis[J].Crit Care201115(3):R149.
13
石岩,刘大为. 降钙素原在全身性感染诊治中的研究进展[J].中华内科杂志201150(5):444-446.
14
胡国豪 陈灵敏 血清降钙素原测定在急性有机磷中毒患者中的意义[J].实用医学杂志 201531(9):1485-1487.
15
张晓凡 李莉 高艳霞 卢广平 黄丽 急性百草枯中毒患者血清降钙素原水平的动态变化及意义[J].临床急诊杂志 201415(10):586-589.
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