百草枯中毒患者血sCD14-T/mCD14水平与病情程度、APACHEⅡ评分有相关性

孔艳艳.百草枯中毒患者血sCD14-T/mCD14水平与病情程度、APACHEⅡ评分有相关性[J].内科急危重症杂志,2023,29(3):222-225

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DOI：10.11768/nkjwzzzz20230311

中文关键词: 百草枯中毒血可溶性CD14分子亚型膜结合CD14 急性生理与慢性健康状况评估评分预后

英文关键词:

基金项目:安徽省教育厅重点课题(No:KJ2015B108by)

作者	单位	E-mail
孔艳艳	蚌埠医学院附属蚌埠第三人民医院急诊内科	13805529866@163.com

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中文摘要:

摘要目的：探讨百草枯中毒患者血可溶性CD14分子亚型（sCD14-T）/膜结合CD14（mCD14）水平变化以及与急性生理与慢性健康状况评估（APACHE Ⅱ）评分的相关性。方法：选取84例百草枯中毒患者，检测入院时血sCD14-T/mCD14水平、APACHE Ⅱ评分，根据《急性百草枯中毒诊治专家共识(2013)》，按病情程度，将患者分为轻度17例，中度42例，重度25例。比较不同病情程度患者血sCD14-T/mCD14水平、APACHE Ⅱ评分，并分析二者相关性，比较不同sCD14-T/mCD14水平、APACHE Ⅱ评分患者预后情况，分析血sCD14-T/mCD14水平、APACHE Ⅱ评分与预后的关系。结果：重度患者血sCD14-T、sCD14-T/mCD14水平、APACHE Ⅱ评分高于中度、轻度患者，且中度患者高于轻度患者，重度患者mCD14水平低于中度、轻度患者，且中度患者低于轻度患者（P均＜0.05）；以百草枯中毒重度为阳性样本，轻、中度为阴性样本，绘制受试者工作特征（ROC）曲线；外周血sCD14-T/mCD14水平联合APACHE Ⅱ评分评估重度百草枯中毒的曲线下面积（AUC）为0.898（95%CI：0.824～0.971）；百草枯中毒患者sCD14-T/mCD14水平与APACHE Ⅱ评分呈正相关（P＜0.05）；sCD14-T/mCD14水平＞3.22、APACHE Ⅱ评分＞23分患者的生存率相较于sCD14-T/mCD14水平≤3.22、APACHEⅡ评分≤23分患者更低（P均＜0.05）；sCD14-T/mCD14水平、APACHE Ⅱ评分为百草枯中毒患者预后的独立危险因素（P均＜0.05）。结论：百草枯中毒患者外周血sCD14-T/mCD14水平随病情加重逐渐升高，与APACHEⅡ评分呈正相关。

英文摘要:

Abstract Objective: To investigate the changes in blood soluble CD14 molecular subtype (sCD14-T)/membrane bound CD14 (mCD14) levels in patients with paraquat poisoning and the correlation with the Acute Physiological Functioning and Chronic Health Status Rating System Ⅱ (APACHE Ⅱ) scores. Methods: A total of 84 patients with paraquat poisoning were selected. According to expert consensus on diagnosis and treatment of acute paraquat poisoning (2013), the patients were divided into mild (17 cases), moderate (42 cases) and severe (25 cases) groups according to the severity of the disease. The sCD14-T/mCD14 levels were determined and APACHE Ⅱ scores were recorded on admission. The blood sCD14-T/mCD14 levels and APACHE Ⅱ scores in patients with different degrees of disease were compared, and the correlation between sCD14-T/mCD14 levels and APACHE Ⅱ scores was analyzed. The prognosis of patients with different sCD14-T/mCD14 levels and APACHE Ⅱ scores was compared, and the relationship between sCD14-T/mCD14 levels, APACHE Ⅱ scores and prognosis was analyzed. Results: Blood sCD14-T and sCD14-T/mCD14 levels, and APACHE Ⅱ scores were higher in severe patients than in moderate and mild patients and higher in moderate patients than in mild patients, and mCD14 levels were lower in moderate and mild patients and lower in moderate patients than in mild patients (all P< 0.05). The area under the curve (AUC) of peripheral blood sCD14-T/mCD14 levels combined with APACHE Ⅱ scores to assess severe paraquat poisoning was 0.898 (95% CI: 0.824-0.971). sCD14-T/mCD14 level of paraquat poisoning patients was positively correlated with APACHEⅡ score (P < 0.05). The survival rate of patients with sCD14-T/mCD14 level >3.22, APACHEⅡ score >23 was lower than that in the patients with sCD14-T/mCD14 level ≤3.22, APACHEⅡ score ≤23 points (P < 0.05). sCD14-T/mCD14 level and APACHEⅡ score were independent risk factors for the prognosis of patients with paraquat poisoning (P < 0.05). Conclusion: The level of sCD14-T/mCD14 in peripheral blood of patients with paraquat poisoning gradually increases with the severity of the disease, and is positively correlated with the APACHE Ⅱ score.