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目的观察急性有机磷中毒中间综合征患者血清肌钙蛋白I(cTnI)及心肌酶谱的变化规律,评价其与心肌损伤的关系、临床意义及预后。方法不同程度的急性有机磷中毒患者63例,按中毒的程度分为轻中度、重度、中间综合征组,分别于中毒的第1、2、3、5、7d采集静脉血3ml,测定血清cTnI和心肌酶谱(CK、CK-MB、LDH、α-HBDH、AST)值,与正常对照组进行比较;同时在中毒的第3天对上述项目再进行比较分析。结果急性有机磷中毒患者血清cTnI和心肌酶谱值均有不同程度升高。血清cTnI在中毒后第2天达高峰,第7天还明显高于对照组(P<0.01),随中毒程度加重,血清cTnI升高越明显,以中间综合征为著,且各组cTnI升高的幅度明显高于心肌酶谱。结论急性有机磷中毒中间综合征患者血清cTnI比心肌酶谱值在血液中升高的时间更早,升高的幅度更明显、持续的时间更长,更具有临床意义,对心肌损伤的早期诊断及预后判断具有更重要的价值。
Objective To observe the changes of serum cardiac troponin I (cTnI) and myocardial enzymes in patients with intermediate syndrome of acute organophosphate poisoning, and to evaluate their relationship with myocardial injury, clinical significance and prognosis. Methods Sixty-three patients with acute organophosphorus poisoning of varying degrees were divided into three groups according to the degree of poisoning: mild, moderate, severe and intermediate syndromes. Venous blood was collected on the first, second, third, cTnI and myocardial enzymes (CK, CK-MB, LDH, α-HBDH, AST) were compared with those of the normal control group. On the third day of poisoning, the above items were compared again. Results Acute organophosphate poisoning serum cTnI and myocardial enzyme values were increased to varying degrees. Serum cTnI peaked on the second day after poisoning, and was significantly higher on the 7th day than that of the control group (P <0.01). With the increase of the degree of poisoning, the serum cTnI increased more obviously, with intermediate syndrome as the index of cTnI rise High amplitude was significantly higher than myocardial enzymes. Conclusions Serum cTnI in patients with intermediate syndrome of acute organophosphorus pesticide poisoning is higher than myocardial enzyme spectrum in blood, and the amplitude of cTnI is earlier, more obvious, longer lasting and more clinical significance, and the early diagnosis of myocardial injury And prognosis have more important value.