Epidemiological characteristics of acute paraquat poisoning in children in southwest Shandong and related factors of pulmonary interstitial fibrosis
10.3760/cma.j.issn.1673-4912.2020.01.007
- VernacularTitle: 鲁西南地区儿童急性百草枯中毒流行病学特征及肺间质纤维化相关因素分析
- Author:
Mengxiao SHEN
1
;
Jinlong LIU
1
;
Lei HAN
2
;
Xuemei SUN
3
;
Shengying DONG
4
;
Chengjun LIU
5
;
Baohai SHI
6
;
Hongfeng ZHU
7
;
Liping CHEN
8
;
Tong CHEN
9
;
Liwen LI
10
;
Bo LI
1
;
Zhaohua ZHANG
2
;
Youpeng JIN
1
Author Information
1. Pediatric Intensive Care Unit, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
2. Affiliated Hospital of Jining Medical College, Jining 272113, China
3. Linyi People′s Hospital, Linyi 276002, China
4. Liaocheng People′s Hospital, Liaocheng 252000, China
5. Linyi Central Hospital, Linyi 276400, China
6. Taian Central Hospital, Taian 271000, China
7. Jining First People′s Hospital, Jining 272113, China
8. Zibo Maternal and Child Health Hospital, Zibo 250022, China
9. Dongying People′s Hospital, Dongying 257000, China
10. The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, China
- Publication Type:Journal Article
- Keywords:
Paraquat poisoning;
Children;
Blood purification;
Pulmonary interstitial fibrosis;
Glucocorticoids
- From:
Chinese Pediatric Emergency Medicine
2020;27(1):30-34
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the epidemiological characteristics of acute paraquat(PQ)poisoning in children in southwest Shandong, and the risk factors for pulmonary interstitial fibrosis.
Methods:This retrospective study was performed on the clinical data of children with acute PQ poisoning admitted from January 2013 to December 2017 in 12 hospitals in southwest Shandong.All participants were divided into pulmonary interstitial fibrosis group and no pulmonary interstitial fibrosis group on the basis of the chest CT 14 days after poisoning.The epidemiological characteristics and risk factors of pulmonary interstitial fibrosis were analyzed.
Results:During the study period, a total of 307 children with acute PQ poisoning were admitted to 12 hospitals, of which 61 (19.87%) were suffering from acute PQ poisoning.Forty-nine cases with complete clinical data were analyzed, including 26 male and 23 female patients poisoned by oral.The age distribution ranged from 8 months to 14 years.Poisoning mainly occured from July to September of each year.The mortality of acute PQ poisoning was 8.2%(4/49), and the incidence of pulmonary interstitial fibrosis in survival patients was 44.4%(20/45). Statistical differences (P<0.05) were found between the pulmonary interstitial fibrosis and no pulmonary interstitial fibrosis, with regard to the times of blood purification, the time from poison exposure to blood purification, the application rate of glucocorticoids, the concentration of PQ in urine, the pediatric critical illness score, the time from poison exposure to gastric lavage, the white blood count at admission, serum creatinine, arterial blood lactate, PaO2, PaCO2, and PaO2/FiO2; however, there was no significant difference in the proportion of blood purification treatment, the mode of blood purification treatment, alanine aminotransferase, aspartate aminotransferase, urea nitrogen, creatine kinase and troponin.Stepwise logistic regression analysis showed that the time from exposure to poison to gastric lavage(OR=0.683, 95%CI 0.210-2.222)and to blood purification(OR=0.0133, 95%CI 0.004-0.042), the times of blood purification(OR=2.862, 95%CI 1.450-5.648), concentration of PQ in urine(OR=1.435, 95%CI 1.085-1.898), and the use of glucocorticoids(OR=0.190, 95%CI 0.048-0.757) were the risk factors for pulmonary interstitial fibrosis(P<0.05).
Conclusion:Early gastric lavage and blood purification, increasing the frequence of adminitrating purification appropriately, using low-dose glucocorticoids can reduce the incidence of pulmonary interstitial fibrosis of children with acute PQ poisoning.
