Objective: To investigate the early predictors of respiratory depression in patients with glufosinate poisoning, and provide reference for clinicians to make decisions. Methods: In March 2022, the clinical data of patients with glufosinate poisoning admitted to the intensive care unit of the Affiliated Xiangshan Hospital of Wenzhou Medical University from March 2018 to January 2022 were retrospectively analyzed. The patients were divided into respiratory depression group and non-respiratory depression group according to the occurrence of respiratory depression during hospitalization. The clinical data such as age, gender, past history, intake, initial treatment and laboratory examination were compared between the two groups. Multivariate logistic regression was used to analyze the predictors of respiratory depression in patients with glufosinate poisoning, and its predictive value was analyzed by receiver operating characteristic (ROC) curve. Results: A total of 34 patients with glufosinate poisoning were enrolled, including 13 patients in non-respiratory depression group and 21 patients in respiratory depression group. There were significant differences in intake, blood amylase and bicarbonate radical in arterial blood gas between the two groups (P<0.05). Respiratory depression occurred at 6.5-48.0 h after ingestion, with a median of 15.0 (9.5, 24.0) h. Multivariate logistic regression analysis showed that the intake of glufosinate (OR=1.440, 95%CI: 1.033-2.009, P=0.032) and bicarbonate radical in arterial blood gas (OR=0.199, 95%CI: 0.040-0.994, P=0.049) were predictors of respiratory depression in patients with glufosinate poisoning, and the area under the curve (AUC) of ROC curves were 0.936 and 0.842. The optimal cut-off values were 15.0 g (sensitivity=95.2%, specificity=76.9%) and 17.6 mmol/L (sensitivity=71.4%, specificity=84.6%), respectively. Conclusion: The intake of glufosinate and bicarbonate radical in arterial blood gas have good prediction effects on the occurrence of respiratory depression in patients with glufosinate poisoning.
目的： 探讨草铵膦中毒患者呼吸抑制的早期预测因素，为临床医师决策提供参考。 方法： 于2022年3月，回顾性分析2018年3月至2022年1月温州医科大学附属象山医院重症监护病房收治的草铵膦中毒患者的临床资料。以住院期间有无发生呼吸抑制分为呼吸抑制组和非呼吸抑制组，比较两组患者的年龄、性别、既往史、摄入量、初始治疗、实验室检查等临床资料，采用多因素logistic回归分析草铵膦中毒患者呼吸抑制的预测因素，通过受试者工作特征（ROC）曲线分析其预测价值。 结果： 共纳入34例草铵膦中毒患者，其中非呼吸抑制组13例，呼吸抑制组21例，两组患者摄入量、血淀粉酶和动脉血气碳酸氢根比较差异有统计学意义（P<0.05）。呼吸抑制发生于摄入后6.5~48.0 h，平均15.0（9.5，24.0）h。多因素logistic回归分析显示，草铵膦摄入量（OR=1.440，95%CI：1.033~2.009，P=0.032）、动脉血气碳酸氢根（OR=0.199，95%CI：0.040~0.994，P=0.049）是草铵膦中毒患者呼吸抑制的预测因素，ROC曲线分析显示曲线下面积（AUC）分别为0.936、0.842，最佳截断值分别为15.0 g（灵敏度95.2%、特异度76.9%）和17.6 mmol/L（灵敏度71.4%、特异度84.6%）。 结论： 草铵膦摄入量、动脉血气碳酸氢根对草铵膦中毒患者呼吸抑制的发生有较好的预测作用。.
Keywords: Glufosinate; Poisoning; Predictors; Respiratory depression.