QT间期在急性一氧化碳中毒中的初步探讨  

Clinical study on QT intervals in acute carbon monoxide poisoning

作　　者：牛开亚[1] 庞谊[2] 杨帆[1] 杨晓燕[1] 承解静[1] 

机构地区：[1]上海中医药大学附属普陀医院急诊内科,200062 [2]上海中医药大学附属普陀医院高压氧科,200062

出　　处：《中国急救医学》2010年第6期540-542,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨QT间期在急性一氧化碳中毒（ACOP）患者中的变化,观察QT间期离散度（QTd）、校正的QT间期离散度（QTcd）与碳氧血红蛋白（COHb）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、肌钙蛋白I（cTnI）及肌红蛋白（Mb）的关系. 方法选取我院住院的ACOP患者104例,另取98例本院内科患者为对照组.在入院时和出院时行心电图检查,分别测量QT间期, 计算QTd 和QTcd,并测定CK、CK-MB、LDH、cTnI及Mb.分析QTcd与CK、CK-MB、LDH、cTnI和Mb的相关性.结果 入院时两组QT值比较差异无统计意义,两组QTd和QTcd比较差异有统计学意义（P＜0.01）.中毒组QT、QTd和QTcd出院时较入院时显著下降（P＜0.01）.入院时QTcd与COHb（r = -0.288,P=0.019）、cTnI（r = -0.297,P=0.007）、CK-MB（r=0.262,P=0.020）和Mb（r=0.248,P=0.012）相关,而与CK和LDH无相关性.结论 ACOP可以引起患者QT间期延长,当QTcd升高时与患者的心肌损伤有相关性.Objective To investigate the changes of QT interval in the patients with acute carbon monoxide poisoning （ACOP） , and to discuss the relationship of QT dispersion （QTd） , corrected QT dispersion （QTcd） with carboxyhemoglobin （COHb） level, creatine kinase （CK）, creatine kinase - MB （ CK - MB ）, lactate dehydrogenase （ LDH ）, troponin I （cTnI） and myoglobin （Mb） daring carbon monoxide poisoning. Methods We conducted an observational study in 104 patients diagnosed with ACOP, and 98 controls in internal medicine department. QT intervals were measured, the QTd and QTcd were calculated on admission and discharge. The COHb, CK, CK - MB, LDH, cTnI and Mb were measured respectively. Results On admission, there were no statistical differences in QT, but there were statistical differences between QTd and QTcd（ P 〈 0. 01 ）. In intoxication group, the QT, QTd and QTcd on admission was significantly higher than that on discharge in ACOP （P 〈 0. 01 ）. QTcd was significantly correlated with COHb level （ r = - 0. 288, P = 0. 019）, cTnI （ r = - 0. 297, P = 0.007）, CK-MB （r=0.262, P=0. 020） and Mb （r=0.248, P=0.012） levels. Conclusion QTc and QTcd significantly increase in ACOP patients, which is correlated with myocardial damage.

关 键 词：急性一氧化碳中毒(ACOP) 碳氧血红蛋白(COHb) QT间期 心电图 

分 类 号：R595.1[医药卫生—内科学]