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Background: This study aimed to establish a high-performance liquid chromatography tandem mass spectrometry method for determining paraquat and diquat in human plasma and predict clinical outcomes.
Methods: Each plasma sample was subjected to methanol protein precipitation and passed through a hydrophilic column and was then analyzed by mass spectrometry to determine paraquat and diquat. Receiver operating characteristic curves were used to calculate herbicide poisoning severity indices and allow herbicide concentrations in plasma to be used to predict clinical outcomes.
Results: The responses to paraquat and diquat in plasma were strongly linear over the range of 20 - 10,000 ng/mL. The limit of quantitation and quality control samples met the required criteria. The paraquat and diquat poisoning severity index was significantly higher for the death group than the survival group (p < 0.05). The areas under the paraquat and diquat poisoning severity index receiver operating characteristic curves were 0.946 and 0.998, respectively, and the optimal clinical critical values were 22.84 and 15.64 (h·mg)/L, respectively, indicating good diagnostic performances for both herbicides.
Conclusions: The method is sensitive, accurate, quick, and specific, so it is highly recommended for clinical use.
DOI: 10.7754/Clin.Lab.2025.250311
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