Evaluation of Lac and NGAL on the Condition and Prognosis of Patients with Diquat Poisoning.

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE Prehospital and Disaster Medicine Pub Date : 2023-10-01 Epub Date: 2023-09-15 DOI:10.1017/S1049023X23006350

Qianqian Zhu, Wenpin Xu, Hongna Qi, Baoyue Zhu, Weizhan Wang

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Abstract

Aim: This study aims to explore the evaluation of lactic acid (Lac) and neutrophil gelatinase-associated lipocalin (NGAL) on the condition and prognosis of patients with diquat (DQ) poisoning.

Methods: A total of 79 cases of DQ poisoning treated in one hospital from January 2019 through February 2023 were included: 10 cases of mild poisoning, 49 cases of moderate to severe poisoning, and 20 cases of fulminant poisoning. According to the Kidney Disease: Improving Global Outcomes-acute kidney injury (KDIGO-AKI) criteria, the patients were divided into 60 cases in the AKI group and 19 cases in the non-acute kidney injury (NAKI) group. According to the AKI diagnostic indicators, AKI patients were divided into Grade I, Grade II, and Grade III. According to prognosis, the patients were divided into survivor group and non-survivor group. During the same period, 30 healthy subjects were selected as the healthy group. The changes of blood Lac, NGAL, cystatin C (CysC), and serum creatinine (Scr) levels of patients were detected, the 28-day survival of patients was recorded, and the correlation between blood Lac, NGAL levels, and renal injury grade in patients with AKI caused by DQ poisoning was analyzed. The receiver operator characteristic (ROC) curve was used to evaluate the predictive value and prognostic value of Lac, NGAL, and their combination in patients with AKI caused by DQ poisoning.

Results: There were significant differences in AKI grade, Lac, NGAL, CysC, and Scr levels among different degrees of poisoning groups (P < .05). There were significant differences in the levels of Lac, NGAL, CysC, and Scr among patients with different AKI grades (P < .05). The levels of Lac, NGAL, CysC, and Scr in the survivor group were significantly lower than those in the non-survivor group (P < .05). The blood Lac and NGAL levels were positively correlated with AKI grades in patients with DQ poisoning (r = 0.752, 0.836; P = .000, .000). The combined detection of blood Lac and NGAL had higher predictive value for AKI and assessed value for death in DQ poisoning than either of them alone.

Conclusion: The combined detection of Lac and NGAL have a certain clinical value in AKI grading and evaluating AKI prognosis caused by DQ poisoning.

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Lac和NGAL对百草枯中毒患者病情和预后的评价。

目的：探讨乳酸（Lac）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）对百草枯（DQ）中毒患者病情和预后的影响。方法：纳入2019年1月至2023年2月在一家医院治疗的79例DQ中毒病例：轻度中毒10例，中度至重度中毒49例，暴发性中毒20例。根据肾脏疾病：改善全球预后急性肾损伤（KDIGO-AKI）标准，将患者分为AKI组60例和非急性肾损伤组19例。根据AKI诊断指标，将AKI患者分为I级、II级和III级。根据预后，将患者分为存活组和非存活组。在同一时期，30名健康受试者被选为健康组。检测DQ中毒引起的AKI患者的血液Lac、NGAL、胱抑素C（CysC）和血清肌酐（Scr）水平的变化，记录患者的28天生存期，并分析血液Lac和NGAL水平与肾损伤程度的相关性。受试者-操作者特征（ROC）曲线用于评估Lac、NGAL及其组合对DQ中毒引起的AKI患者的预测价值和预后价值。结果：不同程度中毒组的AKI分级、Lac、NGAL、CysC和Scr水平存在显著差异（P＜0.05），存活组的血清Lac和NGAL水平与DQ中毒患者的AKI分级呈正相关（r=0.752，0.836；P=.000，.000）。结论：Lac和NGAL联合检测对DQ中毒引起的AKI分级和预后评估具有一定的临床价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prehospital and Disaster Medicine Medicine-Emergency Medicine

CiteScore

3.10

自引率

13.60%

发文量

279

期刊介绍： Prehospital and Disaster Medicine (PDM) is an official publication of the World Association for Disaster and Emergency Medicine. Currently in its 25th volume, Prehospital and Disaster Medicine is one of the leading scientific journals focusing on prehospital and disaster health. It is the only peer-reviewed international journal in its field, published bi-monthly, providing a readable, usable worldwide source of research and analysis. PDM is currently distributed in more than 55 countries. Its readership includes physicians, professors, EMTs and paramedics, nurses, emergency managers, disaster planners, hospital administrators, sociologists, and psychologists.