摘要： 目的 探讨钙通道阻滞剂中毒患者的死亡影响因素。方法 选取中国医科大学附属盛京医院急诊科2014年6月至2021年6月收治的52例钙通道阻滞剂中毒患者的临床资料。记录入院快速急诊内科评分(REMS)、早期预警评分(MEWS)和格拉斯哥昏迷指数(GCS),比较不同预后人群的差异。结果 52例患者中,生存组37例,死亡组15例,死亡率为28.8%。死亡组年龄、白细胞计数、中性粒细胞计数、门冬氨酸氨基转移酶、尿素、肌酐、D-二聚体及REMS评分高于生存组(P<0.05),入院心率、总蛋白、白蛋白及GCS评分则低于生存组(P<0.05)。多因素logistic回归分析结果显示,年龄(OR=1.189,95%CI:1.019~1.388)、入院心率(OR=0.809,95%CI:0.665~0.983)和白细胞计数(OR=1.705,95%CI:1.065~2.729)是影响钙通道阻滞剂中毒患者预后的独立影响因素(P<0.05),三者联合诊断的受试者操作特征(ROC)曲线曲线下面积(AUC)为0.948(P<0.05)。结论 钙通道阻滞剂中毒死亡率高,年龄、入院心率、白细胞计数三者联合诊断可提高诊断灵敏度,REMS评分对预后诊断有重要作用。

52例钙通道阻滞剂中毒患者死亡影响因素分析

钟志涛, 赵敏

中国医科大学附属盛京医院急诊科, 沈阳 110004

收稿日期:2022-03-01出版日期:2022-12-30发布日期:2022-12-12
通讯作者:赵敏E-mail:zhaom@sj-hospital.org
作者简介:钟志涛 (1996-)，男，医师，硕士.



关键词: 钙通道阻滞剂中毒, 死亡影响因素, 入院快速急诊内科评分, 预后
Abstract: Objective The influencing factors for mortality in patients with calcium channel blocker poisoning were analyzed to provide a basis for improving the treatment level of calcium channel blocker poisoning. Methods The clinical data of 52 patients with calcium channel blocker poisoning treated in the emergency department of Shengjing Hospital of China Medical University from June 2014 to June 2021 were collected； these included rapid emergency medicine score(REMS)， modified early warning score(MEWS)， and Glasgow coma scale(GCS)， which were used to analyze the epidemiological data and compare the differences among different prognostic populations. Results Among the 52 patients， 37 were in the survival group and 15 in the death group， with a mortality rate of 28.8%. The age， white blood cell count， central granulocyte count， aspartate aminotransferase， urea， creatinine， D-dimer， and REMS in the death group were higher than those in the survival group(P<0.05). The heart rate， total protein， albumin， and GCS in the death group were lower than those in the survival group(P<0.05). Age(OR= 1.189，95%CI： 1.019-1.388)， heart rate(OR= 0.809，95%CI： 0.665-0.983)， and white blood cell count(OR= 1.705，95%CI： 1.065-2.729) were obtained using multivariate logistic regression analysis. The area under curve(AUC) of the receiver operating characteristic curve(ROC) diagnosed by the combined three factors was 0.948(P<0.05). Conclusion The mortality rate of calcium channel blocker poisoning is high. The combined diagnosis of influencing factors， such as age， admission heart rate， and white blood cell count， can improve the diagnostic sensitivity. REMS plays an important role in the diagnosis of prognosis.
Key words: calcium channel blocker poisoning, influencing factors for death, including rapid emergency medicine score, prognosis
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