和肽素及缺血修饰白蛋白在急性百草枯中毒早期的表达及意义  

Copeptin and ischemia modified albumin expression and significance of early in acute paraquat poisoning

作　　者：李敬[1] 王荣霞[2] 何佳起 张建军[1] 朱保月[1] 李伟[1] 王维展[1] 

机构地区：[1]河北医科大学附属哈励逊国际和平医院EICU,河北衡水053000 [2]河北省衡水市第二人民医院,河北衡水053000

出　　处：《实用临床医药杂志》2014年第16期40-43,共4页Journal of Clinical Medicine in Practice

基　　金：河北省衡水市2012科研基金(12019A)

摘　　要：目的探讨在急性百草枯中毒患者(APP)早期和肽素(copeptin)与缺血修饰白蛋白(IMA)的表达及临床意义。方法选择本院急诊科2010年10月—2013年10月收治的APP患者93例作为中毒组,以住院期间临床死亡作为观察终点,分为存活组45例和死亡组48例。所有入选者在入院后2 h、24 h内抽取静脉血3 mL,检测心肌酶、肌钙蛋白I(cTnI)、IMA、Copeptin水平。结果 2组比较,死亡组口服剂量较存活组有明显差异,而抢救时间、首次灌流时间和灌流次数之间无差别。死亡组入院后2 h Copeptin、IMA水平升高,与存活组比较有显著差异;入院后24 h Copeptin、cTnI、CK、CK-MB水平较存活组明显升高(P<0.05);IMA 2组比较差异无统计学意义。APP患者口服剂量与Copeptin呈正相关,与IMA(ACB值)呈负相关。口服农药剂量越大,Copeptin、IMA升高越明显。2组患者Copeptin、IMA(ACB值)水平呈负相关。回归分析提示:Copeptin、IMA、cTnI、CK、CK-MB与患者口服剂量呈线性关系。结论早期联合检测IMA和Copeptin对早期诊断APP患者心肌损伤有重要意义,其浓度高低与预后相关,即含量越高病情越重,预后越差,因此对评估预后有重要临床价值。Objective To make a discussion on patients with acute paraquat poisoning（APP）early copeptin and ischemia modified albumin expression and its clinical significance. Methods 93 APP patients were selected as the poisoning group,the hospital clinical death as the endpoint,divided into survival group（48 cases） and death group（45 cases）. All patients after admission in 2 h,24 h in blood samples were 3 mL,detection of myocardial enzymes,cTnI,IMA,Copeptin. Results Compared the death group and survival group,Death group of oral dose than the survival group had significant difference. While the rescue time,for the first timeof hemoperfusion and times with no difference. 2h after admission Copeptin,IMA levels elevated,the death group and survival group have significant difference. 24 h Copeptin,cTnI,CK,CK-MB in death group was significantly higher than the survival group（P〈0.05）. IMA comparison between two groups was no significance. Patients with APP oral dose was positively correlated with Copeptin; and IMA（ACB value） was negative correlation. More oral dose,Copeptin,IMA increased significantly. Copeptin was negatively correlated with IMA levels. Regression analysis,suggesting that Copeptin,IMA,cTnI,CK,CK-MB in patients with oral dose showed a linear relationship.Conclusion There is an important significance in early diagnosis of APP myocardial injury in the early detection of IMA and Copeptin,a correlation between concentration and prognosis,which is more severe illness,its content is higher,the worse the prognosis. It has an important clinical value for evaluating prognosis.

关 键 词：急性百草枯中毒 心肌损伤 和肽素 缺血修饰白蛋白 

分 类 号：R542.2[医药卫生—心血管疾病]