ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2022, Vol. 14 ›› Issue (4): 326-330.doi: 10.3969/j.issn.1674-3865.2022.04.013

• 临床研究 • 上一篇    下一篇

儿童毒蕈中毒死亡危险因素分析

龚玲, 卢秀兰, 肖政辉, 黄娇甜李逊   

  1. 410007 长沙，湖南省儿童医院急救中心
  • 收稿日期:2021-08-23 出版日期:2022-08-25 上线日期:2023-11-29
  • 通讯作者: 卢秀兰，E-mail：391118947@qq.com
  • 基金资助:
    儿童急救医学湖南省重点实验室（2018TP1028）

Risk factor analysis of death from mushroom poisoning in children

GONG Ling, LU Xiulan, XIAO Zhenghui, HUANG Jiaotian, LI Xun   

  1. Emergency Center，Hunan Children′s Hospital，Changsha 410007，China

  • Received:2021-08-23 Published:2022-08-25 Online:2023-11-29
  • Contact: LU Xiulan，E-mail：391118947@qq.com

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摘要： 目的 探索儿童毒蕈中毒死亡危险因素，早期发现并及时干预危重型毒蕈中毒，改善预后，降低病死率。方法 回顾性分析2002年6月至2020年12月湖南省儿童医院收治的急性毒蕈中毒患儿51例，以入院时为研究起点，出院或死亡为研究终点。将所有病例分为存活组与死亡组，研究因素包括年龄、性别、住院时间、潜伏期、并发症及器官功能指标等。结果 51例毒蕈中毒患儿中，9例死亡，42例存活。两组间年龄、性别、潜伏期比较差异无统计学意义(P>0.05)。死亡组较存活组住院时间更短，损伤器官数目更多，病情进展更快。死亡组器官功能损伤更严重，表现为死亡组天冬氨酸转氨酶、总胆红素、直接胆红素、血氨、凝血酶原时间(PT)、抗凝血酶Ⅲ(AT3)、国际标准化比值(INR)、肌酸激酶同工酶(CK-MB)、白细胞计数、血小板、乳酸均较存活组明显异常，差异均有统计学意义(P<0.05),而两组间肾功能、电解质无明显差异。通过单因素Logistic回归分析显示，CK-MB、PT、白细胞计数、血氨、总胆红素、直接胆红素、INR、血小板、乳酸均与死亡呈正相关，而AT3与死亡呈负相关。结论 CK-MB、PT、白细胞计数、血氨、总胆红素、直接胆红素、INR、血小板、乳酸上升以及AT3下降均为毒蕈中毒的死亡危险因素。 

关键词:

毒蕈中毒, 死亡, 危险因素, 儿童

Abstract:

Objective To explore the risk factors of death caused by mushroom poisoning in children，in order to make early detection and timely treatment of critical mushroom poisoning，improve prognosis and reduce mortality.Methods A retrospective analysis was performed on 51 children with acute mushroom poisoning admitted to Hunan Children′s Hospital from June 2002 to December 2020，with admission as the starting point of the study and discharge or death as the end point of the study.All cases were divided into survival group and death group，and the study factors included age，gender，hospitalization time，incubation period，complications and organ function indicators.Results Among 51 children with mushroom poisoning，9 died and 42 survived.There was no significant difference in age，gender or incubation period between the two groups (P>0.05).Compared with the survival group，the death group had shorter hospital stay，more damaged organs，and faster disease progression.The organ function damage in the death group was more serious，which was shown by more significant abnormality in aspartate aminotransferase，total bilirubin，direct bilirubin，blood ammonia(NH4)，prothrombin time(PT) and antithrombin Ⅲ(AT3)，international normalized ratio(INR)，creatine kinase isoenzyme(CK-MB)，white blood cell count，platelets and lactate，compared with the survival group，and the differences were statistically significant(P<0.05)，while there was no significant difference in renal function or electrolytes between the two groups.Univariate Logistic regression analysis showed that CK-MB，PT，white blood cell count，NH4，total bilirubin，direct bilirubin，INR，platelets and lactate were all positively correlated with death，while AT3 was negatively correlated with death.Conclusion The increase in CK-MB，PT，white blood cell count，NH4，total bilirubin，direct bilirubin serum，INR，platelets and lactate and the decrease in AT3 are risk factors for death from mushroom poisoning.


Key words:

Mushroom poisoning, Death, Risk factors, Children