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目的:探讨和肽素(copeptin)与缺血修饰白蛋白(ischemia modified albumin,IMA)联合测定在急性氟乙酰胺中毒患者心肌损伤中的临床意义。方法:选择急性氟乙酰胺中毒患者28例,根据分级标准分轻中度组13例、重度组15例。健康体检者30例作为对照组,所有入选者在入院1h、2d抽取静脉血3ml,检测心肌酶、cTnI、IMA、Copeptin水平。结果:病例组不同程度中毒组与对照组比较,入院后1hCopeptin升高、IMA降低,差异有统计学意义。cTnI、心肌酶两组间比较无意义。入院后2dIMA、Copeptin两组间比较无差异。cTnI、心肌酶病例组较对照组升高,不同中毒病例组cTnI、心肌酶与对照组比较均升高,重度较轻中度升高明显,差异有统计学意义(P<0.05)。入院后1h病例组患者Copeptin与IMA水平呈负相关。结论:早期测定IMA、Copeptin水平对急性氟乙酰胺中毒心肌损伤早期诊断及评估预后具有重要临床价值。
Objective: To investigate the clinical significance of copeptin and ischemia modified albumin (IMA) in the diagnosis of myocardial injury in patients with acute fluoroacetamide poisoning. Methods: A total of 28 patients with acute fluoroacetamide poisoning were selected. According to the grading criteria, 13 cases were mild to moderate and 15 cases were severe. Thirty healthy people were taken as the control group. Venous blood 3ml was drawn on 1h and 2d after admission, and the levels of myocardial enzymes, cTnI, IMA and Copeptin were detected. Results: Compared with the control group, the levels of Copeptin increased and the IMA decreased at 1h after admission in the case group with different degrees of poisoning group, the difference was statistically significant. cTnI, myocardial enzymes more meaningless between the two groups. After admission 2IMA, Copeptin no difference between the two groups. The levels of cTnI and myocardial enzymes were higher in the control group than those in the control group. The levels of cTnI and myocardial enzymes in the poisoning cases were significantly higher than those in the control group (P <0.05). At 1 hour after admission, Copeptin was negatively correlated with IMA level. Conclusion: The early determination of IMA and Copeptin levels have an important clinical value in the early diagnosis and prognosis of myocardial injury induced by acute fluoroacetic acidosis.