浙江医学2025，Vol.47Issue(3)：249-256,后插2,9.DOI:10.12056/j.issn.1006-2785.2025.47.3.2024-1291
急性敌草快中毒的死亡风险因素探讨
Discussion on the risk factors for death from acute diquat poisoning
摘要
Abstract
Objective To explore the risk factors for mortality in patients with acute diquat poisoning.Methods The clinical data of 41 patients with diquat poisoning admitted to Department of Emergency of the First Affiliated Hospital of Wenzhou Medical University from August 2018 to April 2024 were collected and analyzed retrospectively.They were divided into survival and death groups according to 28-day clinical outcome.Differences between the two groups in baseline data,clinical symptoms,and laboratory parameters were compared.Scatter plots were used to present the relationship of diquat concentration at admission and time from exposure to the poisoning to the detection of diquat concentrations with prognosis,and logistic curve fitting was performed.ROC curve analysis was conducted on the amount of poison ingested,the time from poisoning to gastric lavage,the average hourly urine output within 12 hours of admission,white blood cell count,lactic acid,creatinine,alanine aminotransferase,procalcitonin,myoglobin,and the concentration of diquat within 12 hours of admission.The optimal cut-off points were identified and patients were divided into low-level and high-level groups accordingly to conduct Kaplan-Meier survival analysis.Subsequently,multivariate Cox regression analysis was used to identify factors influencing acute diquat poisoning outcomes.Results Among 41 cases of acute diquat poisoning included in the study,19 cases(46.34％)survived and 22 cases(53.66％)died.The patients in the survival group had significantly lower levels of the amount of poison ingested,shorter time from poisoning to gastric lavage,fewer blood dialysis needs,fewer kidney dysfunction cases,and fewer occurrences of anuria during hospitalization when compared with the death group.Additionally,their white blood cell count,acid-base values,lactate,creatinine,alanine aminotransferase,aspartate aminotransferase,procalcitonin,creatine kinase,myoglobin,diquat concentration,and the concentration of diquat within 12 hours of admission were all significantly lower compared to the death group.Furthermore,the average hourly urine output within 12 hours of admission was higher in the survival group,with all differences being statistically significant(all P＜0.05).Mutivariate Cox regression analysis revealed that amount of poison ingested,creatinine at admission,procalcitonin,and diquat concentration within 12 hours of admission were risk factors for survival of patients with diquat poisoning(all P＜0.05),while an increased average hourly urine output within 12 hours of admission served as a protective factor(P＜0.05).Conclusion The amount of poison ingested,creatinine,procalcitonin,average hourly urine output within 12 hours of admission,and the concentration of diguat within 12 hours of admission can effectively predict the risk of death in diquat poisoning patients.These indicators are readily available in clinical settings and should be used more widely.关键词
敌草快/风险因素/预后Key words
Diquat/Risk factors/Prognosis引用本文复制引用
李冬,宋文兴,孙蓉蓉..急性敌草快中毒的死亡风险因素探讨[J].浙江医学,2025,47(3):249-256,后插2,9.基金项目
温州市科技局基础性公益科研项目(Y20220499) （Y20220499）
