蘑菇中毒患者的临床特点及死亡危险因素分析

Yan Yang, Ruifei Shao, Jinfang Xue, Xiran Lou, Deyuan Ning, Guobing Chen
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摘要

摘要背景野生食用菌营养丰富,深受人们的喜爱;然而,很少有关于蘑菇中毒患者预后可预测性的实验室研究。因此,本研究旨在分析食用菌中毒患者的临床特点及死亡危险因素。方法对2015 ~ 2021年我院收治的食用菌中毒患者进行回顾性分析。结果共纳入197例蘑菇中毒患者,其中男性100例(50.76%),死亡率为10.66%(21/197)。死亡的患者更可能表现为潜伏期长、谷丙转氨酶、天冬氨酸转氨酶、直接胆红素、总胆红素(TB)、活化的部分凝血活素时间、凝血酶原时间、国际标准化比率、肌酐和血尿素氮。多元logistic回归分析表明,TB水平大于或等于34.2 μmol/L时死亡风险最大,可使死亡风险增加14.588倍(优势比:15.588;95%可信区间:2.088 ~ 116.351),表明结核是急性蘑菇中毒患者死亡的独立危险因素。结论胆红素浓度与死亡率增高有关。总胆红素是蘑菇中毒的独立危险因素。
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Analysis of the clinical features and risk factors of death in patients with mushroom poisoning
Abstract Background Wild edible mushrooms are rich in nutrition and popular with people; however, few laboratory studies are available about the predictability of outcomes among patients with mushroom poisoning. Therefore, this study aimed to analyze the clinical features and death risk factors of patients with mushroom poisoning. Methods Patients with mushroom poisoning admitted to the hospital from 2015 to 2021 were retrospectively evaluated. Results A total of 197 patients with mushroom poisoning were enrolled in this study, of which 100 (50.76%) were males, and the mortality was 10.66% (21/197). Patients who died were more likely to have demonstrated a long latency, high alanine aminotransferase, aspartate aminotransferase, direct bilirubin, total bilirubin (TB), activated partial thromboplastin time, prothrombin time, international normalized ratio, creatinine, and blood urea nitrogen. Multiple logistic regression analysis indicated that TB level greater than or equal to 34.2 μmol/L had the greatest lethal risk and could increase the risk of death by 14.588 times (odds ratio: 15.588; 95% confidence interval: 2.088–116.351), which indicated that TB was an independent risk factor of death in patients with acute mushroom poisoning. Conclusion Bilirubin concentration was associated with the increased likelihood of mortality. Total bilirubin was the independent risk factor of mushroom poisoning.
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