四次甲基二砜四胺中毒血中毒物浓度测定的临床意义  

Clinical significance of serum concentration of tetramethylenesulp-hotetramine in tetramethylenesulphotetramin poisoning

作　　者：马建赋 胡爱民[1] 田炜宁 王琦[1] 刘宏利[1] 盛薇[1] 徐秀萍[1] 

机构地区：[1]空军总医院急诊部,北京100142 [2]宁夏回族自治区平罗县人民医院

出　　处：《中国急救复苏与灾害医学杂志》2015年第9期817-819,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨四次甲基二砜四胺（TET）中毒患者血中毒物浓度测定的临床意义。方法采用气相色谱法测定55例患者（中毒至人院时间0．5—3h）入院时及第3日血中TET含量。计算入院前患者癫痫发作频率。采用速率法测定入院时及入院第3日血清肌酸激酶（CK）、肌酸激酶同工酶（CK—MB）、乳酸脱氢酶（LDH）、天门冬氨酸氨基转移酶（AST）、仪一羟丁酸脱氢酶（HBDH）浓度。入院第3日33例患者行脑电图检查。采用Pearson相关分析软件分析血中TET浓度及血清心肌酶浓度的相关性。采用Spearman秩相关分析软件分析人院时血中TET浓度与癫痫发作频率及第3日脑电图异常程度的相关性。结果入院时血中TET浓度同癫痫发作频率、肌酸激酶浓度呈正相关；入院时血中TET浓度同血清乳酸脱氢酶、肌酸激酶同工酶、谷草转氨酶、d一羟丁酸脱氢酶浓度无相关性；入院时血中TET浓度同入院第3日血中TET浓度有相关性；入院第3日血中TET浓度同血清CK、CK—MB、LDH、AST、仪一HBDH浓度无相关性；入院时血中TET浓度同脑电图异常程度无相关性；入院第3日血中TET浓度同脑电图异常程度呈正相关。结论人院时及入院第3日血中TET浓度可作为衡量病情轻重的重要参考指标。Objective To evaluate the clinical significance of serum tetramethylenesulphotetramine （TET） concentration in patients with TET poisoning. Methods Fifty-five patients, 25 males and 30 females, aged 1.3 ~ 81 were admitted 0.5-3 h after they took TET orally. Samples of peripheral blood were collected on admission and 3 days after admission. Gas chromatography was used to measure the serum TET concentration, and automatic clinical chemistry analyzer was used to detect the concentrations of the myocardial enzymes： creatine kinase （CK）, creatine kinase-MB （CK-MB）, lactate dehydrogenase （LDH）, aspartate transaminase （AST）, and ct-hydroxybutyrate dehydrogenase （a-HBDH）. Electroencephalography was performed on 33 patients 3 days after admission. Pearson correlation analysis was used to analyze the correlation of TET with the concentrations of the myocardial enzymes. Spearman rank correlation analysis was used to analyze the correlation of blood TET with the epilapsy seizure rate and EEG abnormality. Results The blood TET concentration 3d after admission was ？ nmol/L, significantly higher than that on admission. The blood TET concentration on admission was positively correlated with the epilepsy seizure rate. The blood TET concentration on admission was positively correlated with the CK concentration （P 〈 0.001）, and not correlated with the concentrations of CK-MB, LDH, AST, and α-HBDH （all P〉0.05）. The blood TET concentration on admission was positively correlated with blood TET concentration 3d after admission （P 〈 0.01）.Conclusion The concentrations of Tblood ET on admission and 3d after admission can be used as important reference indicators to evaluate yhe severity and prognosis of TET poisoning.

关 键 词：四次甲基二砜四胺 癫痫 肌酸激酶 肌酸激酶同工酶MB 乳酸脱氢酶 谷草转氨酶 Α-羟丁酸脱氢酶 脑电图 

分 类 号：R139.3[医药卫生—劳动卫生]