关键词: 有机磷中毒, 认知功能障碍, 影响因素分析

Abstract: Objective To investigate the influencing factors associated with the occurrence of cognitive dysfunction in patients with acute organophosphorus pesticide poisoning (AOPP). 
Methods One hundred and fifty-six patients with AOPP were selected and divided into the observation group (n=60) and the control group (n=96) according to occurrence of cognitive dysfunction. Clinical data such as duration from poisoning to hospital admission, degree of poisoning, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and recovery time of cholinesterase (CHE) were collected from the two groups to analyze the factors influencing the occurrence of cognitive dysfunction and to construct a prediction model. 
Results There were statistically significant differences in age, poisoning dose, degree of poisoning, CHE recovery time, APACHEⅡ score, and length of hospitalization between observation group and control group (P＜0.05).Logistic regression analysis showed that age, degree of poisoning, recovery time of CHE, APACHEⅡ score, and length of hospitalization were independent risk factors for the development of cognitive dysfunction in AOPP patients (P＜0.05). A logistic regression risk prediction model for the occurrence of cognitive dysfunction in AOPP patients was constructed: -4.782 + age × 2.507 + degree of poisoning × 2.778 + CHE recovery time × 2.646 + APACHEⅡ score × 2.905 + length of hospitalization ×2.320, with a good model fit (P＜0.05).The area under the curve of the model in predicting the occurrence of cognitive dysfunction in AOPP patients was 0.931, with a sensitivity of 83.33% and a specificity of 86.46%. 
Conclusion AOPP patients are prone to cognitive dysfunction, which is mainly influenced by age, degree of poisoning, CHE recovery time, APACHEⅡ score, and length of hospitalization. It is of high value to establish a logistic regression prediction model to predict the occurrence of cognitive dysfunction based on the above factors, and clinical attention should be paid to CHE recovery time and APACHEⅡ score, which is helpful to guide the follow-up treatment and improve the prognosis. 

Key words: organophosphorus poisoning, cognitive dysfunction, analysis of influencing factors