急性杀虫双中毒程度与心、肝和肾损伤的关系  

Relationship between acute bisultap poisoning and heart,liver and kidney injury

作　　者：何仁辉[1] 

机构地区：[1]荆州市荆州区中医院,湖北荆州434020

出　　处：《工业卫生与职业病》2013年第1期13-16,共4页Industrial Health and Occupational Diseases

摘　　要：目的探讨急性杀虫双中毒(ABP)程度与心、肝、肾损伤的关系。方法 67例ABP患者分为轻、中度中毒组(32例)和重度中毒组(35例)。所有患者于入院后第3、7、24、48、72小时进行血清肌钙蛋白I(CTnI)和肌酸激酶同工酶(CK-MB)检测;于入院后第3、24、48小时进行肝、肾功能检测。轻、中度中毒组每8h,重度中毒组每4h检查1次心电图,共3d。结果与30例健康者(对照组)的血清检测指标以及心电图进行比较,ABP患者中毒后3～72h各时点的血清CTnI以及CK-MB值明显高于对照组(P<0.05或P<0.01),重度中毒组各时点的CTnI以及CK-MB值明显高于轻、中度中毒组(P<0.01)。第72小时时点CTnI值略有下降[(0.14±0.04)μg/L],而CK-MB值明显下降[(35.43±10.44)U/L]。重度中毒组心电图异常率(28.57%)明显高于轻、中度中毒组(9.38%)(P<0.01),轻、中度中毒组心电图异常率与对照组比较,差异均无统计学意义(P>0.05)。重度中毒组肝、肾功能异常率明显高于轻、中度中毒组和对照组(P<0.05或P<0.01)。结论 ABP可损伤心肌细胞以及肝、肾功能,且中毒程度越深损伤越重。ABP患者CTnI和CK-MB检测、心电图检查对心肌损伤具有重要临床意义,CTnI的诊断价值可能优于CK-MB。Objective To investigate the relationship between acute bisultap poisoning and heart,liver and kidney injuries.Methods 67 acute bisultap poisoning patients were divided into two groups i.e.the lightly and moderately poisoned group（32 cases）and the severely poisoned group（35 cases）.The troponin I（CTnI）and creatine kinase isoenzyme（CK-MB）levels of all patients were dynamically examined at the 3rd,7th,24th,48th,and 72nd hour,the liver and kidney functions at the 3rd,24th,and 48th hour after admission.The electrocardiograms（ECGs）were examined at an eight hours interval for the lightly and moderately poisoned group and at a four hours interval for the severely poisoned group for three days.ECGs were evaluated in all patients within the 72nd h after hospitalization.30 healthy adults were taken as the control group.Results The serum values of CTnI and CK-MB of the poisoned patients were significantly higher than those of the control group at various time sections（P0.05 or P0.01）.Moreover,the serum values of CTnI and CK-MB of the severely poisoned group were significantly higher than those of the lightly and moderately poisoned group（P0.01）.The serum values of CTnI at the 72nd hour section dropped slightly,but the serum values of CK-MB dropped vigorously.The abnormal rate of ECG of the severely poisoned group（28.57%） was significantly higher than that of the lightly and moderately poisoned group（9.38%）（P0.001）.The difference between abnormal rates of ECG in the lightly and moderately poisoned group and the control group was not statistically significant（P0.05）.The abnormal rates of liver and kidney functions of the severely poisoned group were distinctively higher than those of the lightly and moderately poisoned group and the control group（P0.01）.Conclusions Acute bisultap poisoning could cause heart,liver and kidney injuries,the extent of which correlate with the severity of poisoning.Serum CTnI and CK-MB levels and ECG might have important clinical meaning in evaluating

关 键 词：杀虫双 中毒 肌钙蛋白Ⅰ 肌酸激酶同工酶 

分 类 号：R134[医药卫生—劳动卫生]