百草枯中毒24小时内肺磨玻璃影体积及其早期动态变化的预后价值

发布时间：2018-04-27 13:14

本文选题：百草枯中毒 + 磨玻璃影体积　；参考：《临床放射学杂志》2017年07期

【摘要】：目的探讨百草枯(PQ)中毒24小时内肺CT磨玻璃影(GGO)体积及其早期动态变化与预后的关系。方法回顾性分析58例PQ中毒患者24小时内CT影像学表现,其中,42例有中毒后2天、4天及7天完整的CT随访资料,根据PQ中毒90天内患者的生存情况分为生存组和死亡组,比较两组临床指标、GGO体积及动态变化特点,对具显著差异的客观指标采用Logistic回归分析,寻找有独立预后效应的因子,然后进一步采用ROC曲线分析其预测死亡的效能。采用Kaplan-Meier生存曲线分析GGO组和无GGO组的存活率。结果生存组33例,死亡组25例,GGO体积、血肌酐、PaO_2具有独立预后价值,死亡组24小时内GGO体积显著大于生存组(P0.05)。其预测死亡的敏感性、特异性和准确性分别为96.97%、68%、74%;GGO体积曲线下面积(AUC=0.837)大于血肌酐(AUC=0.832)、PaO_2(AUC=0.739)。GGO组存活率为32.1%,无GGO组则高达80%(P0.05)。生存组GGO体积一周内复查无差异,死亡组则明显升高。结论 PQ中毒24小时内GGO有无、体积大小及其早期动态变化对于判断PQ中毒预后具有客观的临床指导价值。
[Abstract]:Objective to investigate the relationship between the volume and early dynamic changes of lung CT glass-milled glass-gow (GGOA) and prognosis during 24 hours of paraquat PQQ poisoning. Methods the CT findings of 58 patients with PQ poisoning within 24 hours were retrospectively analyzed. 42 patients with PQ poisoning were divided into survival group and death group according to the survival of PQ poisoning within 90 days. The volume and dynamic characteristics of GGO were compared between the two groups. Logistic regression analysis was used to find the independent prognostic factors. Then the ROC curve was used to analyze the efficiency of predicting death. Kaplan-Meier survival curve was used to analyze the survival rate of GGO group and no GGO group. Results 33 cases in survival group and 25 cases in death group had independent prognostic value. The volume of GGO in death group was significantly larger than that in survival group within 24 hours (P 0.05). The sensitivity, specificity and accuracy of predicting death were 96.97 and 96.97, respectively, and the area under the volume curve of GGO was 0.837), which was higher than that of serum creatinine. The survival rate of the GGO group was 32.1%, while that of the non-GGO group was as high as 80P0.050.The survival rate of the GGO group was 32.1%, and that of the GGO group was higher than that of the blood creatinine group (P < 0.05). There was no difference in GGO volume within one week in survival group, but increased significantly in death group. Conclusion the presence, volume size and early dynamic changes of GGO in 24 hours after PQ poisoning have an objective clinical value in judging the prognosis of PQ poisoning.
【作者单位】：安徽医科大学上海临床学院;同济大学附属第十人民医院放射科;
【分类号】：R595.4;R816.41

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