急性乙二醇中毒患者关键实验室检测指标的相关性分析

Correlation Analysis of Key Laboratory Detection Indicators in Patients with Acute Ethylene Glycol Poisoning

摘要: 目的：评估急性乙二醇中毒患者关键实验室检测指标的相关性分析，为急性乙二醇中毒的诊断及评估提供参考。方法：收集我市三家大型综合性三甲医院2010年1月至2022年12月期间诊断急性乙二醇中毒且符合本研究纳排标准的43例患者的临床资料，统计分析关键实验室指标血PH值、钙离子、钠离子、碳酸氢根、钾离子、乳酸、渗透压间隙、阴离子间隙、肌酐及尿素氮的分布特征，并分析彼此间的相关性。结果：血PH值、钙离子、碳酸氢根较正常参考下限显著降低(P < 0.05)；血钾离子、乳酸、渗透压间隙、阴离子间隙、肌酐及尿素氮较正常参考区间上限显著升高(P < 0.05)。血PH值与阴离子间隙存在显著负相关(P < 0.01, r = −0.658)，与钾离子存在显著弱负相关(P < 0.01, r = −0.319)，与乳酸存在显著负相关(P < 0.01, r = −0.438)，与碳酸氢根存在显著极强正相关(P < 0.01, r = 0.813)；阴离子间隙与钠离子存在显著弱正相关(P < 0.05, r = 0.337)，与乳酸存在显著中等程度正相关(P < 0.01, r = 0.500)，与渗透压间隙存在显著弱负相关(P < 0.05, r = −0.362)，与碳酸氢盐存在显著中等程度负相关(P < 0.01, r = −0.494)；钾离子与钙离子存在显著中等程度负相关(P < 0.01, r = −0.467)，与肌酐存在显著弱正相关(P < 0.05, r = 0.305)，与肌酐存在显著弱正相关(P < 0.05, r = 0.380)；乳酸与渗透压间隙呈显著弱正相关(P < 0.05, r = 0.312)，与碳酸氢根存在显著中等程度正相关(P < 0.01, r = 0.570)；渗透压间隙与碳酸氢根存在显著弱正相关(P < 0.05, r = 0.333)；肌酐与尿素氮存在显著极强正相关(P < 0.01, r = 0.845)。结论：急性乙二醇中毒的实验室检测结果表现为严重的阴离子间隙升高型代谢性酸中毒及急性肾损伤伴或不伴渗透压间隙升高，任何不明原因的严重阴离子间隙升高型代谢性酸中毒伴急性肾损伤都应将急性乙二醇中毒作为鉴别诊断考虑在内。

Abstract: Objective: To evaluate the correlation analysis of key laboratory testing indicators in patients with acute ethylene glycol poisoning, and provide reference for the diagnosis and evaluation of acute ethylene glycol poisoning. Method: Clinical data of 43 patients diagnosed with acute ethylene glycol poisoning from three large tertiary hospitals in our city from January 2010 to December 2022, who met the inclusion and exclusion criteria of this study, were collected. The distribution characteris-tics of key laboratory indicators such as blood PH, calcium ions, sodium ions, bicarbonate, potassium ions, lactate, osmotic pressure gap, anion gap, creatinine, and urea nitrogen were statistically ana-lyzed, and their correlations were analyzed. Result: The blood pH, calcium ions, and bicarbonate levels were significantly lower than the normal reference lower limit (P < 0.05); Blood potassium ions, lactate, osmotic pressure gap, anion gap, creatinine, and urea nitrogen significantly increased compared to the upper limit of the normal reference interval (P < 0.05). There is a significant nega-tive correlation between blood PH value and anion gap (P < 0.01, r = −0.658), a significant weak negative correlation with potassium ion (P < 0.01, r = −0.319), a significant negative correlation with lactate (P < 0.01, r = −0.438), and a significant strong positive correlation with bicarbonate (P < 0.01, r = 0.813); There is a significant weak positive correlation between anion gap and sodium ion (P < 0.05, r = 0.337), a significant moderate positive correlation with lactate (P < 0.01, r = 0.500), a significant weak negative correlation with osmotic pressure gap (P < 0.05, r = −0.362), and a signif-icant moderate negative correlation with bicarbonate (P < 0.01, r = −0.494); There is a significant moderate negative correlation between potassium ions and calcium ions (P < 0.01, r = −0.467), a significant weak positive correlation with creatinine (P < 0.05, r = 0.305), and a significant weak positive correlation with creatinine (P < 0.05, r = 0.380); There is a significant weak positive corre-lation between lactate and osmotic pressure gap (P < 0.05, r = 0.312), and a significant moderate positive correlation with bicarbonate (P < 0.01, r = 0.570); There is a significant weak positive cor-relation between osmotic pressure gap and bicarbonate (P < 0.05, r = 0.333); There is a significant positive correlation between creatinine and urea nitrogen (P < 0.01, r = 0.845). Conclusion: The la-boratory test results of acute ethylene glycol poisoning show severe metabolic acidosis with elevat-ed anion gap and acute kidney injury with or without elevated osmotic pressure gap. Any unex-plained severe metabolic acidosis with elevated anion gap and acute kidney injury should be con-sidered as a differential diagnosis of acute ethylene glycol poisoning.