和肽素及缺血修饰白蛋白在急性有机磷农药中毒早期心肌损伤素及缺 .pdfVIP

J South Med Univ, 2015, 35(3): 459-462 doi 10.3969/j.issn. 1673-4254.2015.03.30 ·459 · 基础研究 和肽和肽素及缺血修饰白蛋白在急性有机磷农药中毒早期心肌损伤素及缺血修饰白蛋白在急性有机磷农药中毒早期心肌损伤 中的中的应用应用 李 敬，张建军，李 娜，李 佳，刘 娟，刘 倩 河北医科大学附属哈励逊国际和平医院急诊科，河北 衡水 053000 摘要：目的 探讨和肽素（copeptin）与缺血修饰白蛋白（ischemia modified albumin, IMA）联合测定对急性有机磷农药中毒 （AOPP）心肌损伤早期诊断及预后判断的临床价值。方法 选择AOPP 患者126例为病例组。健康体检者50 例为对照组，所有 患者在入院1 h 内抽取静脉血3 ml ，检测心肌损伤标记物、Copeptin、IMA 水平。结果 病例组与对照组比较，Copeptin、IMA 水平 均升高且有显著差异。重度与轻中度患者比较，IMA、Copeptin水平升高明显，差异有显著统计学意义（P0.05）。经Logistic 回 归分析显示，Copeptin、IMA 水平、重度AOPP 并发症的患者出现心血管事件的危险性增加。结论早期测定Copeptin、IMA 水平 在AOPP 中毒心肌损伤患者的早期诊断有重要意义，其浓度高低与病情轻重呈相关性，即病情越重，其含量越高。对评估预后 具有重要临床价值。 关键词：急性有机磷农药中毒；和肽素；缺血修饰白蛋白 Copeptin and ischemia modified albumin in early diagnosis and prognosis of myocardial damage in acute organic phosphorus pesticide poisoning LI Jing, ZHANG Jianjun, LI Na, LI Jia, LIU Juan, LIU Qian Department of Emergency Medicine, Harrison International Peace Hospital, Hengshui 053000 ,China Abstract: Objective To assess the value of combined detection of copeptin and ischemia modified albumin (IMA) in early diagnosis and prognostic evaluation of myocardial damage in patients with acute organic phosphorus pesticide poisoning (AOPP). Methods A total of 126 AOPP patients were examined for blood copepin and IMA levels and myocardial injury markers within 1 h after admission. Results Copeptin and IMA levels significantly increased in patients with AOPP compared with those in the control subjects. Copeptin and IMA levels were significantly higher in severe AOPP cases than in mild to moderate cases (P0.05). Logistic regression analysis showed that increased copeptin and IMA levels and severe complications of AOPP were associated with an increased risk of cardiovascular events. Conclusion Early detection of copeptin and IMA levels has impo