急性一氧化碳中毒迟发脑病与心肌损伤程度的关系研究  

Relationship between the Severity of Delayed Encephalopathy and the Degree of Myocardial Injury in Acute Carbon Monoxide Poisoning

作　　者：安连朝 武晓宁[2] 栗小提 AN Lian-chao;WU Xiao-ning;LI Xiao-ti(The People's Hospital of Tang County ,Baoding City,Hebei 072350 China)

机构地区：[1]河北省唐县人民医院急诊科,河北保定072350 [2]河北省唐县人民医院心内科,河北保定072350 [3]河北省唐县人民医院骨科,河北保定072350

出　　处：《医学临床研究》2019年第1期15-17,共3页Journal of Clinical Research

基　　金：河北省2014年度医学科学研究重点课题(编号:ZD20140235).

摘　　要：【目的】 探讨急性一氧化碳(CO)中毒迟发型脑病(DEACMP)患者心肌酶学指标的变化及其意义。【方法】 本院收治的60例急性CO中毒(ACMP)患者,其中33例患者发生DEACMP(A组)、27例患者未发生DEACMP(B组),比较两组患者急性期、A组恢复期的血清肌红蛋白(Mb)、肌钙蛋白(cTnI)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)水平和心电图结果。【结果】 A组患者的ST-T改变、Ⅰ度房室传导阻滞、室内传导阻滞的发生率显著高于B组,且差异均有显著性(P<0.05);两组患者的Q-T间期延长、窦性心动过缓、房性期前收缩、室性期前收缩、心房颤动发生率比较差异均无显著性(P>0.05);急性期,A组患者的血清Mb、cTnI、CK-MB、LDH水平显著高于B组(P<0.05);A组患者恢复期的血清Mb、cTnI、CK-MB、LDH水平较急性期显著降低,且差异有显著性(P<0.05)。【结论】 DEACMP患者在急性期的心肌酶学指标较单纯ACMP患者会显著升高,心电图监测结果异常率增加,这些指标有利于早期对DEACMP的发生进行预测及针对性治疗。【Objective】 To investigate the changes and significance of myocardial enzymes in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). 【Methods】 A total of 60 patients with acute carbon monoxide poisoning (ACMP) were enrolled in the study, including 33 patients with DEACMP ( group A) and 27 patients without DEACMP ( group B). Levels of serum myoglobin (Mb), troponin (cTnI), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), aspartate aminotransferase (AST) in the acute phase and DEACMP recovery period were detected and compared in the two groups.【Results】 The incidences of ST-T changes, atrioventricular block (I degree), and indoor block in group A were significantly higher than those in group B (P<0.05). There were no significant differences in QT interval prolongation, sinus bradycardia, atrial premature contraction, ventricular premature contraction, and atrial fibrillation rate between the two groups (P>0.05). In the acute phase, the of patients in A group serum Mb, cTnI, CK-MB and LDH levels in group A were significantly higher than those in group B (P<0.05). The levels of serum Mb, cTnI, CK-MB and LDH in the recovery of group A patients were significantly lower than those in the acute phase, the difference was statistically significant (P<0.05). 【Conclusion】 In the acute phase, the myocardial enzymology index of patients with DEACMP is significantly higher than that of patients with ACMP alone, and the abnormal rate of ECG monitoring results is increased. These indicators are helpful for early prediction and targeted treatment of DEACMP.

关 键 词：一氧化碳中毒/并发症 急性病 脑疾病/病因学 

分 类 号：R595.1[医药卫生—内科学]