急性有机磷农药中毒患者血清肌钙蛋白Ⅰ和左心室功能的变化及其临床意义

摘要

目的 观察急性有机磷农药中毒患者心肌肌钙蛋白Ⅰ (cTn Ⅰ)和左心室功能的变化.方法 测定132例急性有机磷中毒患者(观察组)和50例健康者(对照组)的血清cTn Ⅰ、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)和左心室功能等指标.结果 观察组中、重度亚组患者的血清cTn Ⅰ、左心室等容舒张时间(IVRT)、E波减速时间(EDT)显著高于轻度亚组和对照组(P＜0.05)；左心室射血分数(LVEF)、二尖瓣口舒张早期流速峰值/舒张晚期流速峰值比值(E/A)显著低于轻度亚组和对照组(P＜0.05).结论 有机磷中、重度中毒患者存在心肌损害和左心室功能障碍；与心肌酶检查比较,cTn Ⅰ能更早、更准确地诊断有机磷中毒心肌损害.%Objective To investigate serum cardiac troponin Ⅰ (cTn Ⅰ ) and left ventricular function in patients with acute organic phosphorus poisoning. Methods Serum cTn Ⅰ ,CK,CK-MB,LDH and left ventricular function were measured in 132 patients with acute organic phosphorus poisoning ( experimental group) and 50 healthy subjects( control group). Results The levels of cTn Ⅰ ,IVRT,EDT in moderate or severe poisoning subgroup were significantly higher than those in mild poisoning subgroup and control group (P < 0.05). LVEF and E/A in moderate poisoning or severe poisoning subgroup were significantly lower than those in mild poisoning subgroup and control group(P <0.05). Conclusion There is myocardial injury and left ventricular dysfunction in patients with moderate acute organic phosphorus poisoning. Compared with myocardial enzymes, serum cTn Ⅰ may predict myocardial injury earlier and more accurately in patients with acute moderate organic phosphorus poisoning.