| ObjectiveThe purpose of this study is to investigate the value of uric acid in patients with acute paraquat poisoning.This retrospective study analyzed the clinical data of patients with acute paraquat poisoning admitted from the First Affiliated Hospital of Zhengzhou University from March 2013 to April 2017,and analyzed the relationship between different uric acid concentrations and prognosis of patients with acute paraquat poisoning.MethodThe clinical data of 448 patients with acute paraquat poisoning admitted to the First Affiliated Hospital of Zhengzhou University from March 2013 to April 2017 were collected,including the gender,age,survival time,dose of poisoning,time of poisoning,and admission within 24 hours.Urinary paraquat concentration,white blood cells,hemoglobin,hematocrit,blood potassium,carbon dioxide binding capacity,urea nitrogen,serum creatinine,uric acid,alanine aminotransferase,total bilirubin,creatine kinase,lactate dehydrogenase,D-dimer,prothrombin time and other biochemical indicators,record the patient's in-hospital death and telephone follow-up,define the patient's survival status according to the prognosis within 30 days after poisoning,and summarize the above data to establish a database;divide the patient into the low uric acid group?n=16 cases?,the normal uric acid group?n=300 cases?,and the high uric acid group?n=132 cases?according to the uric acid concentration.The baseline data of the three groups were compared.The Kaplan-Meier method was used to estimate the survival rate of the three groups and to map survival.The curves were compared and the survival time of the three groups of patients was compared.The Cox proportional hazard model was used to analyze the relationship between uric acid and prognosis of patients with acute paraquat poisoning.ResultsA total of 448 patients with acute paraquat poisoning were enrolled in this study,including 212 males and 236 females.188 patients died within 30 days after admission,with a cumulative mortality rate of 42%.Compared with the baseline data of the three groups,the high uric acid group had higher dosage,WBC,UREA,SCr,ALT,total bilirubin,CK,LDH,Hb,Hct and mortality,while the CO2-CP group had the lowest mortality,and the difference was statistically significant?p<0.001?.The survival curve showed that the survival rate of the three groups decreased gradually with the increase of uric acid level,and the average survival time of the high uric acid group was the shortest.The difference was statistically significant?P<0.001?.The results of unadjusted COX proportional hazard model showed that RR?95%CI?in low uric acid group and high uric acid group were 0.133?0.019,0.954?and 1.653?1.234,2.213?respectively,compared with normal uric acid group;After adjusting for gender and age,the RR?95%CI?of death in the low uric acid group and the high uric acid group were 0.125?0.017,0.897?and 1.912?1.401,2.610?respectively.After further adjusting the dosage,urinary PQ concentration,WBC,Hb,Hct,CO2-CP,UREA,SCr,ALT,CK,LDH and total bilirubin,the RR?95%CI?of the uric acid group and the high uric acid group were 0.162?0.023,1.162?and 1.684?1.213,2.336?respectively.ConclusionUric acid has a certain guiding significance for the prognosis of patients with acute paraquat poisoning.High uric acid concentration increases the risk of death from acute paraquat poisoning,while low uric acid concentration may reduce the risk of death from acute paraquat poisoning.Treatment with uric acid lowering may increase survival in patients with acute PQ poisoning.This may provide a simple and reliable indicator of the prognosis of acute paraquat poisoning and provide a new direction for the treatment of acute paraquat poisoning. |
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