慢性酒精中毒患者心肌酶活性变化及临床意义

摘要

目的 探讨慢性酒精中毒患者心肌酶活性的变化情况和临床意义.方法 选择我院入院时心肌酶各项指标异常增高的慢性酒精中毒256例作为研究组,同期入院但心肌酶各项指标在正常范围内的慢性酒精中毒128例作为对照组,于治疗前及治疗后2、4周进行心肌酶、肌钙蛋白检测,同时使用阳性与阴性症状量表(PANSS)评定病情.结果 研究组入院时及治疗后2周心肌酶及PANSS中有关兴奋行为条目的 评分与对照组比较差异均有统计学意义(P<0.01);治疗后4周上述各项指标与对照组比较差异无统计学意义(P＞0.05).研究组治疗后2、4周上述各项指标与入院时比较差异亦均有统计学意义(P<0.01).治疗前及治疗后2、4周两组肌钙蛋白始终为阴性.结论 慢性酒精中毒患者心肌酶升高并非由心肌细胞受损引起,其兴奋谵妄状态与心肌酶活性密切相关.%Objective To explore the change of activity of myocardial enzymes in patients with chronic alcoholic Intoxication and its clinical significance．Methods 256 patients with chronic alcoholic intoxication and with abrormal high levels of myocardial enzymes were regarded as study group，128 chronic intoxicated patients with normal range of myocardial enzymes were regarded as the control group at the same time．Both groups were examined for the levels of serum myocardial enzymes and troponin before treatment and 2，4 weeks after treatment．Meanwlile，illness conditions were determined by the Positive and Negative Syndrome Scale(PANSS)．Results Before treatment and 2 weeks after treatment，there were significant differences in the levels of myocardial enzymes and troponin，and behavior excitement PANSS scores between the two groups (P＜0．01)；All the indicators in study group showed significant differences before and 2 and 4 weeks after treatment(P＜0.01)，but no obvious difference was found in control group before and 4 weeks after treatment(P＞0．05)．Troponin in both groups was negative before and 2 and 4 weeks after treatment．Conclusion The inerease of myocardial enzymes levels in the patients with chronic alcoholic intoxication may not be induced by myocardial damage，but their excitement and delirium may be related with myocardial enzymes activity．