血清肌钙蛋白I对急性有机磷中毒继发心脏损害的诊断和治疗价值  

Clinical Value of Cardiac Troponin Ⅰ in Diagnosis and Treatment of Cardiac Damage Secondary to Acute Organophosphorus Pesticide Poisoning

作　　者：吴佳颖 王大明[1] 杨波[1] WU Jia-ying;WANG Da-ming;YANG Bo(Department of Emergency,The Third Affiliated Hospital of Soochow University,Changzhou,Jiangsu,213003)

机构地区：[1]苏州大学附属第三医院急诊科,213003

出　　处：《岭南急诊医学杂志》2021年第5期453-455,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨血清肌钙蛋白I(cTnI)对急性有机磷中毒(AOPP)继发心脏损害的临床价值。方法:选取2015年1月1日至2020年12月31日苏州大学附属第三医院急性有机磷中毒患者50例,采用回顾性单中心研究方法,根据入院后48 h的cTnI检测结果将患者分为cTnI升高组(升高组)和cTnI正常组(正常组),比较两组入院时血压、电解质和乳酸水平、胆碱酯酶活力等,比较两组间机械通气使用情况、总住院时间及28天病死率。结果:升高组与正常组血钾和乳酸水平及机械通气使用率均有明显差异(P均<0.05)。两组间血压、血糖、胆碱酯酶水平、肌酐、中毒诊断分级、总住院时间、28天病死率无明显差异(P>0.05)。结论:AOPP继发心脏损害的发生率达16%,部分表现为心电图正常的隐匿性心肌损伤。cTnI作为心肌损伤的特异性标志物,在评价AOPP患者预后中也有重要作用。Objective:To investigate the clinical value of cardiac troponin I(cTnI)in diagnosis and treatment of cardiac damage secondary to acute organophosphorus poisoning(AOPP). Methods:Fifty cases of AOPP were treated in the hospital from Jan 2015 to Dec 2020. This was a retrospective and observational study. The cases were divided into two groups according to the c TnI within 48 h. The blood pressure,electrolyte and lactic acid level,cholinesterase(ChE)activity and other conditions dosage forms between the elevated group and normal group. Furthermore,c TnI and creatine kinase MB(CK-MB)were used to calculate the incidence of cardiac damage secondary to AOPP. Finally,the use of mechanical ventilation,total length of hospital stayand 28 days mortality were compared between the two groups. Results:There were significant differences in serum potassium and lactic acid levels between cTnI elevated group and normal group. In terms of prognosis,the utilization rate of mechanical ventilation between the two groups was statistically significant(P<0.05). There was no significant difference in blood pressure,blood glucose,cholinesterase level,creatinine,diagnosis grade of poisoning,total length of hospital stay and in-hospital mortality between the two groups(P>0.05). Conclusion:The incidence of cardiac damage secondary to AOPP was 16%,and some of them are manifested as hidden myocardial damage with normal electrocardiogram. At the same time,cTnI,as a specific marker of myocardial injury,also plays an important role in evaluating the prognosis of patients with AOPP.

关 键 词：急性有机磷中毒 心脏损害 血清肌钙蛋白I 预后 

分 类 号：R595.4[医药卫生—内科学] R541[医药卫生—临床医学]