Correlation Analysis Between Biochemical Indicators And Outcome Of Patients With Acute Mushroom Poisoning

Objective: Retrospective analysis of clinical data by the first hospital of dalian medical university’s treated 114 cases of acute mushroom poisoning(MP) during the period of 2002 to 2014,which were selected as the research object. Our aim is to study the differences between the clinical laboratory indicators of mushroom poisoning in Dalian between patient survival group and death group and find relevant risk factors for death in patients with mushroom poisoning. To investigate the timing and significance of blood purification treatment.Methods: During the period of 2002 to 2014 were selected in our hospital EICU ward in 114 cases of poisonous mushroom poisoning patients as the research object.The diagnosis of poisonous mushroom poisoning was based on a story of mushroom ingestion,patients were divided into two groups as the survival group and the fatality group.Orbit admission, 24 h, 48 h, 72 h of alanine aminotransferase(ALT),total bilirubin(total bilirubin, TB), prothrombin time(PT), international normalized ratio(INR), blood ammonia, creatinine(SCRE) changes during the death group and survival group. Compare changes in ALT、TB、 PT、INR、blood ammonia、creatinine between the survival group and death group laboratory biochemical indicators at different time points.Patients with risk factors for poisonous mushroom poisoning death row ROC curve.the comparisons of laboratory characteristics were made using Student’s t-test if data were normally distributed and Mann-Whitney U test otherwise.numerical varables Count data were presented as the frequency and rate,count data was made analyzed with x2 test. Measurement data were presentedas mean ± standard deviation(Mean ± SD), all the data were statistically analyzed using SPSS17.0 software, the standard is 0.05, when P <0.05 when not statistically significant.The result:1. The age composition of the two groups, the average age of death group and survival group was older(50.27 ± 12.34 V S52.13 ± 7.72), P = 0.689, the difference between the two groups was not statistically significant.2. Time from ingestion poisoning to hospitalization between he death group and survival group was significantly prolonged,(74.10 ± 20.10VS34.3 ± 17.31),P = 0.001,which was significant difference. the longer is the time from ingestion to hospitalization the more severe is the illness.3. The comparison of two-sample t-test analysis,we found that: The alanine aminotransferase level of death group was obviously higher than that of survival group level, the difference between the two groups was statistically significant(t=7.550、6.568、6.311、8.454,p 均<0.01);The TB level of death group was obviously higher than that of survival group, the difference between the two groups was statistically significant(t=7.550、6.568、6.311、8.454,p 均<0.01);The Amon level of death group was obviously higher than that of survival group, the difference between the two groups was statistically significant(t′=5.336、6.568、6.311、8.454,p 均<0.01);The PT level of death group was obviously higher than that of survival group level, the difference between the two groups was statistically significant(t′=4.962、6.879、4.052、3.149,p 均<0.01);The INR level of death group was obviously higher than that of survival group level, the difference between the two groups was statistically significant.with the progress of the treatment((t′=4.401、10.019、6.743、6.165,p 均<0.01);The creatine level of the death group is a little higher than the nomal level,the creatine level of survival group is nomal, the difference between the two groups was not statistically significant(t′=2.334、2.291、2.252、2.250,p 均>0.05).4. By using Spearman analysis method on different time point ALT level, TBIL level, AMON level、PT level、INR level and clinical outcome do correlation analysis found: at different time points ALT levels and clinical outcome were positivelycorrelated(r = 0.377, 0.536, 0.571, 0.542, P <0.01); the level of TBIL and clinical outcome at different time points were positively correlated(r = 0.642, 0.659, 0.624,0.671, P <0.01); the levels of AMON and clinical outcome at different time points were positively correlated(r = 0.701, 0.699, 0.700, 0.699, P <0.01). the levels of PT and clinical outcome at different time points were positively correlated(r = 0.677, 0.695,0.659, 0.701, P <0.01); the levels of INR and clinical outcome at different time points were positively correlated(r=0.659, 0.677, 0.706, 0.707, P<0.01);the intensity of correlation of ALT(48h), TB(72h), AMON(0h) PT(72h), INR(72h) and clinical outcome is the most strong.5. The survival rate is not obvious difference.among Plasma exchange(PE) group,Hemoperfusion(HP)combined with Hemofiltration(HF)group 、 Hemoperfusion(HP)combined with Plasma exchange(PE) group,Hemoperfusion(HP)and Hemofiltration(HF) combined with Plasma exchange(PE) group.( P>0.05) 。 P(PE group vs HP+PE group) =0.198,P(PE group vs HP+HF group)=0.667,P(PE group vs PE+HP+HF group) =0.094, P(HP+HF group vs HP+PE group) =0.578,P(HP+HF group VS HP+HF+PE group)=0.702,P(HP+PE 组 VS HP+HF+PE 组)=0.701。Conclusion:1.the treatment delay time of poisonous mushroom poisoning is the longer, the illness is more severe.early diagnosis, early treatment to reduce mortality.2. Biochemistry variables was correlated with poor prognosis, which contain Alanine aminotransferase, Total bilirubin, Prothrombin time, International standardization ratio and Blood ammonia.3.the death cause of poisonous mushroom poisoning is mainly liver failure.Poisonous mushroom toxin mainly damage liver.