Analyze the risk factors of secondary myocardial injury to acute organophosphorus pesticide poisoning and the predictive value of serum Furin and sTWEAK for it
10.3969/j.issn.1673-4130.2024.20.010
- VernacularTitle:急性有机磷农药中毒继发心肌损伤的危险因素及血清Furin、sTWEAK对其的预测价值分析
- Author:
Rui LI
1
;
Wei ZHU
;
Jie XU
;
Yarong XIE
Author Information
1. 运城市中心医院检验科,山西运城 044000
- Keywords:
acute organophosphorus pesticide poisoning;
myocardial injury;
furin protease;
soluble tumor necrosis factor-like weak inducer of apoptosis;
prediction power
- From:
International Journal of Laboratory Medicine
2024;45(20):2480-2484
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of myocardial injury secondary to acute organophos-phorus pesticide poisoning(AOPP)and the predictive efficacy of serum Furin and soluble tumor necrosis fac-tor-like weak inducer of apoptosis(sTWEAK).Methods A total of 146 AOPP patients admitted to this hos-pital from February 2021 to February 2023 were selected as the research objects.Three days after admission,they were divided into non-myocardial injury group(84 cases)and myocardial injury group(62 cases)accord-ing to whether they had secondary toxic heart disease.The clinical data of all patients were collected.Univari-ate and multivariate Logistic regression analysis were used to explore the risk factors of secondary myocardial injury in AOPP patients.The serum Furin and sTWEAK levels of all patients were detected by enzyme-linked immunosorbent assay.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum Furin and sTWEAK for secondary myocardial injury in AOPP patients.Results Myocardial injury occurred in 62 of 146 AOPP patients,with an incidence of 42.47％.Univariate analysis showed that there were no statistically significant differences in gender,time from medication to admission,and pesticide type between the two groups(P＞0.05).Compared with the non-myocardial injury group,the myocardial in-jury group had significantly higher levels of tropomin Ⅰ and creatine kinase isoenzyme and a significantly high-er proportion of patients with age ≥60 years,severe poisoning,and acute physiology and chronic health evalu-ation(APACHE)Ⅱ score ≥20(P＜0.05).The serum levels of Furin and sTWEAK in the myocardial injury group were higher than those in the non-myocardial injury group(P＜0.05).The area under curve(AUC)of serum Furin and sTWEAK in predicting secondary myocardial injury in AOPP patients was 0.813 and 0.744,respectively.The AUC of combined prediction of the two was 0.896,which was higher than that of each index alone.Multivariate Logistic regression analysis showed that severe poisoning degree(OR=2.054,95％CI 1.256-3.360),APACHE Ⅱ score ≥20 points(OR=2.323,95％CI 1.334-4.046),serum Furin≥129.48 ng/L(OR=3.380,95％CI 1.689-6.766),serum sTWEAK≥845.86 ng/L(OR=4.988,95％CI 2.057-12.097)were risk factors for secondary myocardial injury in AOPP patients(P＜0.05).Conclusion Seconda-ry myocardial injury in AOPP patients is related to the degree of poisoning and APACHE Ⅱ score,and the ser-um Furin and sTWEAK levels increase in patients with secondary myocardial injury in AOPP,which have im-portant clinical significance in predicting patients with secondary myocardial injury in AOPP.
