| Paraquat(PQ)is an efficient herbicide widely used in agricultural production.It has the advantages of strong herbicidal power,rapid action and no pollution to the environment,but it is highly toxic to humans and animals.Acute lung injury(ALI)is the main cause of death.The mechanism of paraquat poisoning was well-researched on many aspects,but the effect of PQ on the lymphocyte and subgroups has not been investigated yet.Objective To investigate the relationship between lymphocyte dysfunction and ALI induced by paraquat poisoning.Methods 92 PQ-poisoned patients admitted to Shanghai Tenth People’s Hospital with PQ poisoning between January,2013 and March,2016 were selected.Laboratory indicators and basic information within 24 hours of hospital admission were collected.Peripheral lymphocyte subsets were detected by flow cytometry.CT scanning and quantitative CT lesions of lung were measured after PQ intoxication within 5 days.The mortality was evaluated according to a follow up of 90-day.Cox proportional hazard analysis was performed to determine the independent risk factors of mortality.Results Of total 92 patients,36(39.1%)died.Lymphocyte count and CD4+/CD8+ T cell ratio were significantly higher but Natural killer(NK)cell ratio was lower in non-survivors than survivors(P<0.001),and all of them were associated with the volume ratio of Ground Glass Opacity(P<0.001).Lymphocyte count,CD4+/CD8+ T cell ratio and NK cell ratio were the independent predictors of mortality in multivariate analysis.(Lymphocyte:hazard ratio[HR]= 1.417;95%[CI],1.026-1.957;P=1.417.CD4+/CD8+ T cell ratio:hazard ratio[HR]= 2.667;95%[Cl],1.596-4.459;P<0.001;NK cell:hazard ratio[HR]= 0.916;95%[CI],0.855-0.982;P=0.014).Conclusion Lymphocyte count,CD4+/CD8+ T cell ratio and NK cell ratio are related to the mortality in patients of PQ poisoning.T lymphocyte and NK cell may participate in PQ-induced acute lung injury. |
