Severity and prognosis of acute organophosphorus pesticide poisoning are indicated by C-reactive protein and copeptin levels and APACHE II score

Wu,Xinkuan; Xie,Wei; Cheng,Yuelei; Guan,Qinglong

doi:10.3892/etm.2016.2982

March-2016 Volume 11 Issue 3

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March-2016 Volume 11 Issue 3

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Article Open Access

Severity and prognosis of acute organophosphorus pesticide poisoning are indicated by C-reactive protein and copeptin levels and APACHE II score

Authors:
- Xinkuan Wu
- Wei Xie
- Yuelei Cheng
- Qinglong Guan
View Affiliations / Copyright

Affiliations: Department of Emergency, Affiliated Hospital of Taishan Medical University, Tai'an, Shandong 271000, P.R. China, Department of Peripheral Vascular Interventional Radiology, Affiliated Hospital of Taishan Medical University, Tai'an, Shandong 271000, P.R. China

Copyright: © Wu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 806-810
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Published online on: January 12, 2016

https://doi.org/10.3892/etm.2016.2982
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Abstract

The aim of the present study was to investigate the plasma levels of C‑reactive protein (CRP) and copeptin, in addition to the acute physiology and chronic health evaluation II (APACHE II) scores, in patients with acute organophosphorus pesticide poisoning (AOPP). A total of 100 patients with AOPP were included and divided into mild, moderate and severe groups according to AOPP diagnosis and classification standards. Blood samples were collected from all patients on days 1, 3 and 7 following AOPP. The concentrations of CRP and copeptin in the plasma were determined using enzyme‑linked immunosorbent assay. All AOPP patients underwent APACHE II scoring and the diagnostic value of these scores was analyzed using receiver operating characteristic curves (ROCs). On days 1, 3 and 7 after AOPP, the levels of CRP and copeptin were increased in correlation with the increase in AOPP severity, and were significantly higher compared with the control groups. Furthermore, elevated CRP and copeptin plasma levels were detected in patients with severe AOPP on day 7, whereas these levels were reduced in patients with mild or moderate AOPP. APACHE II scores, blood lactate level, acetylcholine esterase level, twitch disappearance time, reactivating agent dose and inability to raise the head were the high‑risk factors that affected the prognosis of AOPP. Patients with plasma CRP and copeptin levels higher than median values had worse prognoses. The areas under curve for ROCs were 0.89, 0.75 and 0.72 for CRP levels, copeptin levels and APACHE II scores, respectively. In addition, the plasma contents of CRP and copeptin are increased according to the severity of AOPP. Therefore, the results of the present study suggest that CRP and copeptin levels and APACHE II scores may be used for the determination of AOPP severity and the prediction of AOPP prognosis.

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1	Wang Y, Lin K, Wu D, Wang Z, Wang Q, Mi X and Liu C: Clinical investigations of changes in serum enzymes and C-reactive protein in patients with acute toxification. Zhong Guo Wei Zhong Bing Ji Jiu Yi Xue. 16:55–56. 2004.(In Chinese).
2	Wang Z, Lv Y and Cui T: Analysis of cause of death by acute organophosphorus pesticide poisoning. Zhong Guo She Qu Yi Shi. 14:106–107. 2012.(In Chinese).
3	Han L and Cui X: Application of intestinal protection in adjuvant therapy of severe organophosphorus poisoning. Shi Yong Yao Wu Yu Lin Chuang. 13:154–156. 2010.(In Chinese).
4	Katan M, Morgenthaler N, Widmer I, Puder JJ, König C, Müller B and Christ-Crain M: Copeptin, a stable peptide derived from the vasopressin precursor, correlates with the individual stress level. Neuro Endocrinol Lett. 29:341–346. 2008.PubMed/NCBI
5	Li H, Zhao C and Qiu Q: Clinical characteristics and prognosis of ICU patients with severe acute organic phosphorus poisoning. Xian Dai Zhong Xi Yi Jie He Za Zhi. 17:1812–1813. 2008.(In Chinese).
6	Zhang X, Li Q, Liu Y and Zhao J: Determination of blood amylase in patients with acute organophosphorus pesticide poisoning. Zhong Guo Wei Zhong Bing Ji Jiu Yi Xue. 12:4332000.(In Chinese).
7	Wang J, Liu H, Yang Y, Zhang R and Zhang Z: Clinical meaning of morphologic alteration of neutrophils in the patients with acute organic phosphorus poisoning. Zhong Guo Ji Jiu Yi Xue. 22:561–562. 2002.(In Chinese).
8	Pan D and Zhang Z: Clinical value of high sensitivity C-reactive protein on AOPP and prognosis of patients with the disease to determine. Hua Bei Mei Tan Yi Xue Tuan Xue Bao. 13:599–600. 2011.(In Chinese).
9	Zhang H, Ren G, Yin J and Sun W: Copeptin expression in patients with acute organophosphorus poisoning and its clinical significance. Shi Yong Yi Xue Xa Zhi She. 29:576–578. 2013.(In Chinese).
10	Zheng X: Current situation and advance of APACHE-II score in the clinical application. Yi Xue Zong Shu. 17:3297–3298. 2011.(In Chinese).
11	Sam KG, Kondabolu K, Pati D, Kamath A, Kumar Pradeep G and Rao PG: Poisoning severity score, APACHE II and GCS Effective clinical indices for estimating severity and predicting outcome of acute organophosphorus and carbamate poisoning. J Forensic Leg Med. 16:239–247. 2009. View Article : Google Scholar : PubMed/NCBI
12	Akdur O, Durukan P, Ozkan S, Avsarogullari L, Vardar A, Kavalci C and Ikizceli I: Poisoning severity score, Glasgow coma scale, corrected QT interval in acute organophosphate poisoning. Hum Exp Toxicol. 29:419–425. 2010. View Article : Google Scholar : PubMed/NCBI
13	Dai Z, Shi Y and Nei KX: Practice of Internal Medicine (13th). Beijing, China: People's Health Publishing House. 1723–1724. 2009.
14	Knaus WA, Draper EA, Wanger DP and Zimmerman JE: APACHE II. A severity of disease classification system. Crit Care Med. 13:818–829. 1985. View Article : Google Scholar : PubMed/NCBI
15	Li J, Wang R and He J: Copeptin and ischemia modified albumin expression and significance of early in acute paraquat poisoning. Shi Yong Lin Chuang Yi Xue Za Zhi. 18:40–43. 2014.(In Chinese).
16	Hu N, Huang M and Li W: The value of APACHE II scoring system in assessment of severity and prognosis of patients with organophosphate insecticide poisoning. Hua Zhong Ke Ji Da Xue Tong Ji Yi Xue Yuan. 12:25–29. 2011.(In Chinese).
17	Deng Y, Wang F, Sun H and Wang X and Wang X: Risk factor in the patients with intermediate syndrome after acute organophosphorus pesticides poisoning. Zhong Guo Ji Jiu Yi Xue. 28:704–706. 2008.(In Chinese).