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目的探讨急性硫化氢中毒病人心电图异常表现的特点及对心肌损害的预后判断。方法入院时对465例急性硫化氢中毒患者进行标准导联心电图检查。结果 465例病人中心电图异常325例,占69.89%,其中轻度、中度和重度中毒病人心电图异常的发生率分别为31.40%、88.75%和96.99%。中度和重度中毒患者心电图异常发生率明显高于轻度中毒患者(P<0.01),ST-T异常在中度和重度中毒病人中发生率分别为42.50%和48.87%,明显高于轻度中毒病人(P<0.01),重度中毒病人ST段抬高及心律失常发生率与轻度和中度中毒相比差异有统计学意义(P<0.01)。结论急性中度和重度硫化氢中毒患者的心电图异常发生率较高,心肌缺血缺氧为心电图异常表现的主要特点,重度中毒者的心肌损伤心电图表现显著增加。
Objective To investigate the characteristics of abnormal electrocardiogram (ECG) and prognosis of myocardial damage in patients with acute hydrogen sulfide poisoning. Methods 465 cases of acute hydrogen sulfide poisoning patients admitted to the standard lead electrocardiogram. Results Among 465 patients, electrocardiogram was abnormal in 325 cases (69.89%). The incidences of electrocardiogram abnormalities were 31.40%, 88.75% and 96.99% respectively in mild, moderate and severe poisoned patients. The incidence of electrocardiogram abnormality in patients with moderate and severe poisoning was significantly higher than that in mild poisoning patients (P <0.01). The incidences of ST-T abnormalities in moderately and severely poisoned patients were 42.50% and 48.87%, respectively, which were significantly higher than those in mild (P <0.01). The incidence of ST segment elevation and arrhythmia in severe poisoning patients were significantly different from those of mild and moderate poisoning (P <0.01). Conclusions The incidence of electrocardiogram abnormalities in patients with acute moderate and severe hydrogen sulfide poisoning is high. Myocardial ischemia and hypoxia are the main features of ECG abnormalities. The ECGs of myocardial injury in severely poisoned patients are significantly increased.