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1、急性百草枯中毒患者的肾功能指标变化及其临床意义doi：10.3969/j.issn.1007-614x.2014.14.40摘要目的:探讨急性百草枯(Parqual,PQ)中毒的肾功能指标动态变化及其临床意义。方法：对中毒组(43例)和对照组(20例)进行血清胱抑素(CysC)、肌酊(CREA)、尿素氮(BUN)、B2-微球蛋白(B2-MG)及尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的测定，依据对照组和中毒存活组、死亡组的肾功能指标的变化结果进行统计学分析。结果：急性PQ屮毒患者死亡组的急性肾功能异常显著高于存活组，在CysC
2、和NGAL测量值的动态变化上显著高于存活组；CysC以1.94umol/L为截断点时，预测急性PQ中毒患者死亡的敏感度66.7%,特异性95.6%；尿NGAL以58.64Ug/L为截断点时，预测急性PQ中毒患者死亡的敏感度72.2%,特异性91.1%。结论：急性卩Q中毒患者早期出现肾功能异常提示预后不佳。动态监测CysC和尿NGAL变化可指导临床治疗。关键词百草枯中毒急性肾损伤血清胱抑素Thechangesandclinicalsignificanceofrenalfunctioninpatientswithacuteparaqua
3、tpoisoningLiJingl,LiYong2,TianJianyuan2,ShouSongtao(Authorforcorrespondence)1,LiTeng2EmergencyDepartmentofGeneralHospitalAffiliatedtoTianjinMedicalUniversity,3000521EmergencyDepartmentofAffiliatedIlospitaiofJiningMedicalCollegeofJiningCityinShandongProvince2720002,Abst
4、ractObjective:Toexplorethedynamicchangesoftheindexesofrenalfunctionanditsclinicalsignificanceofacuteparaquatpoisoning.Methods：SerumcystatinC(CysC),creatinine(CREA),bloodureanitrogen(BUN),32-microglobulin(B2-MG)andurinaryneutrophilgelatinaseassociatedlipocalin(NGAL)ofpo
5、isoninggroup(43cases)andcontrolgroup(20cases)weremeasured.Weobservedthechangesinrenalfunctionindexesofthecontrolgroup,thepoisoningsurvivalgroup,andpoisoningdeathgroup,andtookstatisticalanalysis.Results：InpatientswithacutePQpoisoning,acuterenaldysfunctionofpoisoningdeat
6、hgroupwassignificantlyhigherthanthesurvivalgroup.DynamicchangesofCysCandNGALmeasurementsweresignificantlyhigherthanthesurvivalgroup.WhentheCysCwith1.94umol/Lwasasthecut-offpoint,thesensitivityofpredictionofdeathinpatientswithacutePQpoisoningwas66.7%,specificitywas95.6%
7、.WhentheUrinaryNGALwith58.64Pg/Lwasasthecut-offpoint,thesensitivityofpredictionofdeathinpa/tientswithacutePQpoisoningwas72.2%,specificitywas91.1%.Conclusion:InpatientswithacutePQpoisoning,earlyrenalfunctionabnormalitiespredictpoorprognosis.Dynamicmonitoringofthechanges
8、ofCysCandurinaryNGALcanguideclinicaltreatment.KeywordsPQpoisoning；Acutekidneyinjury；SerumcystatinC百草枯(］，10-二甲基-4,40-联
