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

被引:2
作者
肖福霞 [1 ]
彭鲲 [2 ]
张九龙 [2 ]
Nekitsing Indima [2 ]
徐婷婷 [2 ]
汤光宇 [1 ]
机构
[1] 安徽医科大学上海临床学院
[2] 同济大学附属第十人民医院放射科
关键词
百草枯中毒; 磨玻璃影体积; 动态变化; 预后;
D O I
10.13437/j.cnki.jcr.2017.07.015
中图分类号
R595.4 [药物中毒]; R816.41 [肺部];
学科分类号
1002 ; 100201 ; 1001 ; 100105 ; 100207 ; 100602 ;
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、PaO2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(P<0.05)。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)、PaO2(AUC=0.739)。GGO组存活率为32.1%,无GGO组则高达80%(P<0.05)。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。
引用
收藏
页码:976 / 980
页数:5
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