初始血乳酸水平与急性口服百草枯中毒患者预后的相关性分析

doi:10.3969/j.issn.1002-1949.2018.08.017

Chinese Journal of Critical Care Medicine

2018, Vol. 38

Issue (8): 724-727 DOI: 10.3969/j.issn.1002-1949.2018.08.017

Correlation analysis of initial blood lactate level with prognosis of acute oral paraquat poisoning

Wu Jia-li, Ji Xiao-jing, Ma Xiao, Yang Li-shan

Department of Emergency, General Hospital of Ningxia Medical University, Yinchuan 750004, China

Abstract
Figure/Table
References (13)
Related Citation (4)

Download: PDF (443 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the relationship between initial lactate (Lac) level and prognosis with acute oral paraquat poisoning patients. Methods This is a retrospective analysis study, including 51 acute oral paraquat poisoning patients information from January 2010 to December 2015 who were admitted to hospital and were divided into five groups according to Lac level. Lac level, gender, age, poisoning to treatment time, poisoning to gastric lavage time and other related information were collected to analyze the relationship of patients′ initial Lac level. Cox proportional hazards model was used for univariate and multivariate analysis, the relationship between different Lac levels and the prognosis of patients was analyzed, and the survival curve was drawn through Kaplan-Meier. Results The median dose of 51 oral paraquat patients were 30 (30, 50) mL, the paraquat qualitative test results showed that weak positive case were 5 (9.8%), positive case were 4 (7.8%), strongly positive case were 42(82.4%). Among all patients, death cases were 34 (66.7%) and the survival cases were 17 (33.3%). Univariate analysis showed that oral paraquat dose, paraquat urine qualitative tests and Lac levels correlated with patient outcome. After adjusting the urine test, oral paraquat dose, treatment time and gastric lavage time, the Cox Proportional Hazard Model showed that the patients prognosis had statistical significance at the level of 6 mmol/L≤Lac<8 mmol/L (HR11.96, 95%CI2.52～56.72) and Lac≥8 mmol/L (HR7.83, 95%CI2.08～29.37), compared with the level of 0 mmol/L≤Lac<2 mmol/L of Lac (P<0.01). The survival curves of patients under different Lac levels showed that the survival rate of patients also gradually decreased with the increase level of Lac, the difference was statistically significant (P<0.01). Conclusion The initial Lac level in acute oral paraquat poisoning is correlated with the prognosis of patients. The higher the Lac level, the higher the risk of death and the lower the survival time.

Key words： Paraquat poisoning Blood lactate(Lac) Initial blood lactate level Oral administration

Corresponding Authors: Yang Li-shan, E-mail: nyfyyls@126.com

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Wu Jia-li
	Ji Xiao-jing
	Ma Xiao
	Yang Li-shan

Cite this article:

Wu Jia-li,Ji Xiao-jing,Ma Xiao, et al. Correlation analysis of initial blood lactate level with prognosis of acute oral paraquat poisoning[J]. Chinese Journal of Critical Care Medicine, 2018, 38(8): 724-727.

URL:

http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2018.08.017 OR http://www.cnemergency.org.cn/EN/Y2018/V38/I8/724

［1］袁晓春, 吴嘉荔, 金晶,等. 尿百草枯定性试验在百草枯中毒中的应用［J］. 宁夏医学杂志, 2016, 38(12):1219-1220. ［2］孟兆华, 苏小云, 宫玉,等. 272例急性百草枯中毒患者早期预后影响因素分析［J］. 中国急救医学, 2017, 37(4):352-358,284. ［3］Min YG, Ahn JH, Chan YC, et al. Prediction of prognosis in acute paraquat poisoning using severity scoring system in emergency department［J］. Clin Toxicol (Phila), 2011, 49(9):840-845. ［4］中国医师协会急诊医师分会. 急性百草枯中毒诊治专家共识(2013)［J］. 中国急救医学, 2013, 33(6):484-489. ［5］陈敏, 朱日进, 陈锋,等. 动脉血乳酸值及乳酸清除率对急性中毒预后影响分析［J］. 齐齐哈尔医学院学报, 2015, 26:3906-3908.［6］Xu S, Hu H, Jiang Z, et al. APACHE score, Severity Index of Paraquat Poisoning, and serum lactic acid concentration in the prognosis of paraquat poisoning of Chinese Patients［J］. Pediatr Emerg Care, 2015, 31(2): 117-121. ［7］Lee Y, Lee JH, Seong AJ, et al. Arterial lactate as a predictor of mortality in emergency department patients with paraquat intoxication［J］. Clin Toxicol (Phila), 2012, 50(1): 52-56. ［8］Novaes RD, Goncalves RV, Cupertino MC, et al. Acute paraquat exposure determines dose-dependent oxidative injury of multiple organs and metabolic dysfunction in rats: impact on exercise tolerance［J］. Int J Exp Pathol, 2016, 97(2): 114-124. ［9］Mascie-Taylor BH, Thompson J, Davison AM. Haemoperfusion ineffective for paraquat removal in life-threatening poisoning［J］. Lancet, 1983, 1(8338):1376-1377. ［10］Sun L, Li GQ, Yan PB, et al. Prediction of outcome following paraquat poisoning by arterial lactate concentration-time data［J］. Exp Ther Med, 2014, 8(2): 652-656. ［11］Odom SR, Howell MD, Silva GS, et al. Lactate clearance as a predictor of mortality in trauma patients［J］. J Trauma Acute Care Surg, 2013, 74(4):999-1004. ［12］Fukushima T, Tanaka K, Lim H, et al. Mechanism of cytotoxicity of paraquat［J］. Environ Health Prev Med, 2002, 7(3):89-94. ［13］余海放, 何庆. 百草枯中毒与全身炎症反应及NF-κB的关系［J］. 华西医学, 2008, 23(1):179-180.