急性百草枯中毒患者早期血心肌酶的表达及对猝死的预警作用  

Expression of Serum Myocardial Enzymes in Patients with Acute Paraquat Poisoning and its Prediction for Sudden Cardiac Death

作　　者：史晶[1] 高渝峰[1] 刘青[1] 

机构地区：[1]广州市第十二人民医院广州市化学中毒救援中心急诊科,510620

出　　处：《岭南急诊医学杂志》2010年第1期42-43,共2页Lingnan Journal of Emergency Medicine

基　　金：广州市医药卫生科技项目(项目编号:2009-YB-111)

摘　　要：目的:分析急性百草枯中毒患者早期血清心肌酶的表达水平,探讨其对预测发病后猝死的意义。方法:检测52例急性百草枯中毒患者(中毒时间<24 h)入院时的心肌酶谱。根据患者的临床结局分为猝死组(生存时间≤1 d)和非猝死组(即生存时间>1d)。比较两组患者入院时的心肌酶谱和APACEⅡ评分。结果:猝死组心肌酶水平显著高于非猝死组(P<0.01),猝死组的中毒剂量显著大于非猝死组(P<0.01)。结论:急性百草枯中毒猝死组患者的心肌酶活性显著增高,且与中毒剂量相关;中毒后血清心肌酶活性的显著升高可能是发生猝死的一个预警指标。Objective： To evaluate the expression level of serum myocardial enzymes in patients with acute paraquat poisoning and its prediction for the onset of sudden cardiac death. Methods： Myocardial enzymes at admission of 52 patients with acute paraquat poisoning （poisoning of time〈24 hours） were detected. According to the clinical outcomes, patient data were dichotomized into two groups： sudden cardiac death group （survival time ≤ 1 day） and non-sudden cardiac death group （survival time 〉1 day）. Patients in two groups were evaluated using APACE Ⅱ score. The association of the sudden cardiac death with myocardial enzymes at admission was further analyzed. Results： Enzymes in patients with sudden cardiac death group were significantly higher than that in the nonsudden cardiac death group （P〈0.01）. The toxic dose in patients with the sudden cardiac death group was significantly higher than that in patients with the non-sudden cardiac death group（P 〈 0.01）. Conclusion： The levels of serum myocardial enzymes in patients after acute paraquat poisoning were significantly high in the subgroup with sudden death and associated with the toxic dose. Increasing level of serum myocardial enzymes may predict the occurrence of sudden death .

关 键 词：百草枯 中毒 心肌酶 猝死 

分 类 号：R595.4[医药卫生—内科学] R743.34[医药卫生—临床医学]