有机磷中毒早期心肌损伤患者血清NT-proBNP、IL-18、α-HBDH水平变化及临床意义  

Changes of serum NT-proBNP.IL-18 andα-HBDH levels in patients with early myocardial injury after organophosphorus poisoning and their clinical significance

作　　者：肖文 胡长新[1] 周士娣 XIAO Wen(Emergency Intensive Care Unit(EICU)of Yongcheng People's Hospital,Shangqiu 476600,Henan,China)

机构地区：[1]永城市人民医院急诊重症监护病房,河南商丘476600

出　　处：《牡丹江医学院学报》2024年第1期47-50,63,共5页Journal of Mudanjiang Medical University

摘　　要：目的 探讨血清N端B型脑钠肽前体(N-terminal B-type brain natriuretic peptide precursor, NT-proBNP)、白细胞介素-18(interleukin-18,IL-18)、α-羟丁酸脱氢酶(α-hydroxybutyrate dehydrogenase, α-HBDH)水平变化对有机磷中毒继发早期心肌损伤患者的影响。方法 选取2017年1月至2023年6月我院收治的有机磷中毒患者171例,根据入院3 d内是否发生心肌损伤分为心肌损伤组(n=32例)和非心肌损伤组(n=139例),比较两组入院时及入院1、3 d和不同中毒程度患者血清NT-proBNP、IL-18、α-HBDH,分析血清NT-proBNP、IL-18、α-HBDH对有机磷中毒继发心肌损伤的影响。结果 心肌损伤组入院时及入院1 d、3 d血清NT-proBNP、IL-18、α-HBDH均高于非心肌损伤组(P<0.05)。中重度中毒心肌损伤患者入院时及入院1 d、3 d血清NT-proBNP、IL-18、α-HBDH均高于轻度中毒心肌损伤患者(P<0.05)。血清NT-proBNP、IL-18、α-HBDH高水平的有机磷中毒患者继发心肌损伤分别是低水平的2.515倍、3.623倍、2.775倍,95%可信区间分别为1.758~3.597、2.325~4.865、1.946~3.958。血清NT-proBNP、IL-18、α-HBDH单独预测有机磷中毒继发心肌损伤的AUC分别为0.826、0.768、0.763,联合预测的AUC明显大于各指标单一预测(P<0.05)。结论 血清NT-proBNP、IL-18、α-HBDH与有机磷中毒继发心肌损伤明显相关,可作为有机磷中毒继发心肌损伤的预警指标,联合检测三者或可成为预测继发心肌损伤一个方案。Objective To investigate the effect of serum N-terminal B-type brain natriuretic peptide precursor(NT-proBNP).interleukin-18(IL-18).α-hydroxybutyrate dehydrogenase(α-HBDH)levels on early myocardial injury secondary to organophosphorus poisoning.Methods A total of one hundred and seventy-one patients with organophosphorus poisoning admitted to Yongcheng People's Hospital from January 2017 to June 2023 were selected and divided into myocardial injury group(n=32 cases)and non-myocardial injury group(n=139 cases)according to whether myocardial injury occurred within 3 days of admission.Serum NT-proBNP.IL-18 andα-HBDH were compared between the two groups at admission.1 and 3 days after admission and patients with different poisoning degrees.and the effects of serum NT-proBNP.IL-18 andα-HBDH on secondary myocardial injury of organophosphorus poisoning were analyzed.Results Serum NT-proBNP.IL-18 andα-HBDH in the myocardial injury group were higher than those in the non-myocardial injury group at admission and 1 and 3 days after admission(P<0.05).Serum NT-proBNP.IL-18 andα-HBDH in patients with moderate and severe myocardial injury were higher than those in patients with mild myocardial injury at admission and 1 and 3 days after admission(P<0.05).The secondary myocardial damage in patients with high levels of serum NT-proBNP.IL-18 andα-HBDH were 2.515 times.3.623 times and 2.775 times of those with low levels.respectively.with 95%confidence intervals of 1.758~3.597.2.325~4.865 and 1.946~3.958.The AUC of serum NT-proBNP.IL-18 andα-HBDH for predicting secondary myocardial injury of organophosphorus poisoning were 0.826.0.768 and 0.763.The AUC of combined prediction was significantly greater than that of single prediction(P<0.05).Conclusion Serum NT-proBNP.IL-18 andα-HBDH are significantly correlated with the secondary myocardial injury of organophosphorus poisoning and can be used as early warning indicators of the secondary myocardial injury of organophosphorus poisoning.Combined detection of the three may be a s

关 键 词：有机磷中毒 心肌损伤 N端B型脑钠肽前体 白细胞介素-18 Α-羟丁酸脱氢酶 

分 类 号：R595.4[医药卫生—内科学]