Abnormal pancreatic enzymes and their prognostic role after acute paraquat poisoning

被引:29
|
作者
Li, Yi [1 ]
Wang, Meng [2 ]
Gao, Yanxia [3 ]
Yang, Wen [4 ,5 ]
Xu, Qun [6 ]
Eddleston, Michael [7 ]
Li, Li [3 ]
Yu, Xuezhong [1 ]
机构
[1] Peking Union Med Coll Hosp, Emergency Dept, Beijing 100730, Peoples R China
[2] Capital Med Univ, Beijing Tiantan Hosp, Dept Sci & Technol, Beijing 100050, Peoples R China
[3] Zhengzhou Univ, Affiliated Hosp 1, Emergency Dept, Zhengzhou 450052, Peoples R China
[4] Chinese Acad Med Sci, Inst Med Informat, Beijing 100020, Peoples R China
[5] Peking Union Med Coll, Beijing 100020, Peoples R China
[6] Chinese Acad Med Sci, Sch Basic Med, Peking Union Med Coll, Dept Epidemiol & Biostat,Inst Basic Med Sci, Beijing 100005, Peoples R China
[7] Univ Edinburgh, Pharmacol Toxicol & Therapeut, Edinburgh, Midlothian, Scotland
来源
SCIENTIFIC REPORTS | 2015年 / 5卷
关键词
SCORING SYSTEM; APACHE-II; SEVERITY; PLASMA; SURVIVAL; LEVEL; PREDICTION; MANAGEMENT; KIDNEY;
D O I
10.1038/srep17299
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Ingestion of paraquat causes multi-organ failure. Prognosis is best estimated through measurement of blood paraquat concentrations but this facility is not available in most hospitals. We studied the prognostic significance of abnormal pancreatic enzymes for survival. Patients with acute paraquat poisoning were recruited. An extensive series of blood tests including serum amylase were serially checked. Patients were sorted according to their serum amylase activity (normal [<220 U/L], mildly elevated [220 to 660 U/L], elevated [>660 U/L]), and survival compared between groups. 177 patients were enrolled to the study, of whom 67 died and 110 survived. 122 (70.62%), 27 (15.25%) and 25 (14.13%) patients were in the normal, mildly elevated and elevated amylase activity groups, respectively. The case fatality in the elevated group was 100% compared to 17% in the normal group (P < 0.001). We found four independent factors for paraquat death prediction: amylase, PaCO2, leukocyte number, and neutrophil percentage. Models using pancreatic enzyme activity showed good prediction power. We have found that abnormal pancreatic enzymes are useful prognostic marker of death after acute paraquat poisoning. Including serum amylase activity into a prognostic model provides a good prognostication.
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页数:8
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