摘要
目的探讨急性一氧化碳中毒(ACOP)患者早期血常规、肾功能、肝功能、凝血功能、心肌酶、动脉血乳酸(LA)、C反应蛋白(CRP)及头部CT与病情严重程度的关联性。方法选取2020年1月1日至2023年6月1日收治于中南大学湘雅医学院附属常德医院并依据《2022年急性一氧化碳中毒诊治专家共识》明确诊断的ACOP患者,将其分为轻度中毒组(n=111)和中重度中毒组(n=43),采集患者入院时血常规、肾功能、肝功能、凝血功能、心肌酶、LA、CRP及头部CT样本等相关数据。采用Logistic风险回归分析筛选出ACOP严重程度的影响因素,并通过受试者操作特征曲线分析相关指标对ACOP严重程度的预测价值。结果多因素Logistic回归分析显示天冬氨酸转氨酶(AST)(O^R:1.01,95%CI:1.00~1.02)、凝血酶原时间(PT)(O^R:0.45,95%CI:0.22~0.86)、纤维蛋白原(FIB)(O^R:1.34,95%CI:1.04~1.77)、凝血酶时间(TT)(O^R:0.71,95%CI:0.50~0.97)、LA(O^R:1.23,95%CI:1.02~1.50)、CRP(O^R:1.03,95%CI:1.01~1.05)、头部CT异常(O^R:8.86,95%CI:3.03~29.08)为ACOP患者病情严重程度的独立危险因素(P<0.05)。模型预测ACOP患者病情严重程度的曲线下面积为0.884(95%CI:0.818~0.950)(P<0.001),灵敏度为0.837,特异度为0.883,表明该模型在预测ACOP患者病情严重程度方面与实际情况有较好的区分度。结论AST、PT、FIB、TT、LA、CRP、头部CT异常是ACOP病情严重程度的独立危险因素,临床可根据上述指标,及早制定干预措施。
【Objective】To investigate the correlation between early blood routine,renal function,hepatic function,coagulation function,cardiac enzymes,arterial blood lactic acid(LA),C-reactive protein(CRP),and head CT and the severity of the disease in patients with acute carbon monoxide poisoning(ACOP).【Methods】ACOP patients admitted to Changde Hospital Affiliated to Xiangya School of Medicine from January 1,2020 to June 1,2023 and diagnosed according to the"2022 Expert Consensus on Diagnosis and Treatment of Acute Carbon Monoxide Poisoning"were selected and divided into a mild poisoning group(n=111)and a moderately-severe poisoning group(n=43).Relevant data such as blood routine,renal function,hepatic function,coagulation function,cardiac myokine enzyme,LA,CRP and head CT samples were collected from patients at the time of admission.Logistic risk regression analysis was used to screen out the factors influencing the severity of ACOP,and the predictive value of the related indexes on the severity of ACOP was analyzed through the reciever operating characteristic curve.【Results】Multifactorial logistic regression analysis showed that AST(O^R:1.01,95%CI:1.00–1.02),prothrombin time(PT)(O^R:0.45,95%CI:0.22–0.86),fibrinogen(FIB)(O^R:1.34,95%CI:1.04–1.77),thrombin time(TT)(O^R:0.71,95%CI:0.5–0.97),LA(O^R:1.23,95%CI:1.02–1.50),CRP(O^R:1.03,95%CI:1.01–1.05),and head CT abnormality(O^R:8.86,95%CI:3.03–29.08)were independent risk factors for the severity of disease in ACOP patients(P<0.05).The area under the curve of the model in predicting the severity of disease in ACOP patients was 0.884(95%CI:0.818-0.950,P<0.001),with a sensitivity of 0.837 and a specificity of 0.883,indicating that the model had a good differentiation from the actual situation in predicting the severity of disease in ACOP patients.【Conclusion】AST,PT,FIB,TT,LA,CRP,and head CT abnormalities are independent risk factors for the severity of ACOP,and clinical interventions can be formulated early according to the above indicators.
作者
申佩
钟怡
SHEN Pei;ZHONG Yi(Department of Neurology,Changde Hospital Affiliated to Xiangya School of Medicine,Central South University,Changde,Hunan 415000,China)
出处
《中国医学工程》
2025年第5期40-45,共6页
China Medical Engineering
基金
湖南省常德市科技局技术创新引导项目(CDKJJ20220615)。
关键词
急性一氧化碳中毒
凝血功能
动脉血乳酸
C反应蛋白
头部CT
acute carbon monoxide poisoning
coagulation function
arterial blood lactic acid
C-reactive protein
head CT
