急性氟乙酰胺中毒患者和肽素与缺血修饰白蛋白在早期诊断和预后评估中的意义  

Copeptin and IMA changes of the patients and its clinical significance in acute fluoroacetamide poisoning

作　　者：李敬[1] 李颖[2] 张建军[1] 王荣霞[2] 刘倩[1] 李佳[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]衡水市第二人民医院

出　　处：《临床急诊杂志》2015年第1期12-14,共3页Journal of Clinical Emergency

基　　金：河北省衡水市2012科研基金资助课题项目(No:12019A)

摘　　要：目的:探讨和肽素(copeptin)与缺血修饰白蛋白(ischemia modified albumin,IMA)联合测定在急性氟乙酰胺中毒患者心肌损伤中的临床意义。方法:选择急性氟乙酰胺中毒患者28例,根据分级标准分轻中度组13例、重度组15例。健康体检者30例作为对照组,所有入选者在入院1h、2d抽取静脉血3ml,检测心肌酶、cTnI、IMA、Copeptin水平。结果:病例组不同程度中毒组与对照组比较,入院后1hCopeptin升高、IMA降低,差异有统计学意义。cTnI、心肌酶两组间比较无意义。入院后2dIMA、Copeptin两组间比较无差异。cTnI、心肌酶病例组较对照组升高,不同中毒病例组cTnI、心肌酶与对照组比较均升高,重度较轻中度升高明显,差异有统计学意义(P<0.05)。入院后1h病例组患者Copeptin与IMA水平呈负相关。结论:早期测定IMA、Copeptin水平对急性氟乙酰胺中毒心肌损伤早期诊断及评估预后具有重要临床价值。Objective： To investigate the clinical significance of copeptin and IMA combined determination in myocardial injury in patients with acute fluoroacetamide poisoning. Method; 28 patients with acute fluoroacetamide poisoning,according to the degree of poisoning were divided into mild to moderate group 13 cases, 15 cases of se- vere group. 30 healthy subjects were selected as control group, all patients on admission, 1 h and 2 d of venous blood 3 mL, detect myocardial enzyme, cTnI, IMA, Copeptin. Result： Patients with varying degrees of poisoning group compared with the control group,Copeptin increased,IMA decreased l h after admission, the difference was statistically significant. CTnI,myocardial enzyme of two groups had no significance. Admission to the 2D, IMA, Copeptin between the two groups showed no difference. CTnI,myocardial enzymes in poisoning group were higher than that in the control group, the difference has statistical significance. CTnI, myocardial enzymes in different poi- soning group compared with the control group increased, severe group than in mild to moderate group increased ob- viously,the difference has statistical significance. （P〈0.05）. After admission in patients with 1 H group Copeptin was negatively correlated with IMA level,related with the degree of intoxication was positive,IMA was negatively correlated with the degree of poisoning. 2 D after admission,linearly related cases in groups CK,CKMB, cTnI levels and the degree of poisoning. Conclusion： Early determination of IMA, Copeptin level has important significance in early diagnosis of myocardial injury in patients with acute fluoroacetamide poisoning,its concentration level was re- lated to the severity of the illness,that is,the higher its content. It has an important clinical value in the assessment of prognosis.

关 键 词：急性氟乙酰胺中毒 心肌损伤 和肽素 缺血修饰白蛋白 诊断 预后 

分 类 号：R542.2[医药卫生—心血管疾病]