急性一氧化碳中毒致心肌损害临床观察  

Clinical research on acute carbon monoxide poisoning causing myocardial injury

作　　者：高文丽[1] 邸丕凡[1] 赵丽萍[1] 史红[1] 

机构地区：[1]河北大学附属医院,河北保定071000

出　　处：《医学研究与教育》2010年第2期35-36,39,共3页Medical Research and Education

摘　　要：目的探讨急性一氧化碳(acute carbon monoxide poisoning,ACOP)中毒患者血清心肌酶及心电图变化,了解对心肌损害情况。方法对44例急性CO中毒患者(轻度中毒组17例、中度中毒组9例、重度中毒18例)入院后24h内抽取空腹静脉血测定肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(HBDH)、天门冬氨酸氨基转移酶(AST),并常规描记体表心电图。结果急性轻度CO中毒患者血清心肌酶与正常对照组差异无统计学意义(P>0.05);中、重度中毒患者较轻度中毒患者明显增高(P<0.05),且中毒程度越重心肌酶越高;急性CO中毒可致心电图出现ST-T和各种心律失常改变。结论急性中、重度CO中毒患者存在心肌损害,中毒程度越深,心肌损害越重;CO中毒可致不同类型心电图改变。Objective To explore the changes of serum myocardial enzymes and electrocardiogram caused by ACOP （acute carbon monoxide poisoning） to know the degree of myocardial injury. Methods Within 24 hours after they were sent to the hospital, the blood of the 44 cases of acute CO poisoning patients（mild poisoning group of 17 cases, moderate poisoning group of 9 cases, severe poisoning group of 18 cases were tested to determine their creatine kinase （CK）, creatine kinase isozymes （CK-MB）, lactate dehydrogenase （LDH）, alpha hydroxyl butyrate dehydrogenase（HBDH）sand aspartic acid amine shift enzyme（AST）, at the same time the ecg cardiography was adopted to know the changes of electrocardiogram of the patients. Results There was no significant difference of the serum myocardial enzymes between the group of mild CO poisoning and the controled group （P〉 0.05） and the serum myocardial enzymes of the middle and severe poisoning patients increases obviously （P〈0.05）, what＇s more the higher degree of poisoning, the higher degree of the serum myocardial enzymes. Acute CO poisoning could cause electrocardiogram to appear ST-T and all kinds of arrhythmia change. Conclusion Myocardial may be caused within patients of CO poisoning with middle or severe degree. The higher degree of poisoning, the higher degree of the serum myocardial enzymes. CO poisoning can cause different types of ecg changes.

关 键 词：CO中毒 心肌酶 心电图 

分 类 号：R5[医药卫生—内科学]