急性一氧化碳中毒并发心肌损伤临床研究.docVIP

精品论文 参考文献 急性一氧化碳中毒并发心肌损伤临床研究 侯志岭 赵军国 高丽芳（山西省阳泉市第一人民医院急诊科 045000） 【中图分类号】R595.1【文献标识码】A【文章编号】1672-5085（2012）26-0164-03 【摘要】目的 探讨急性一氧化碳中毒(ACOP)时心电图改变，心肌酶、肌钙蛋白（CTNT）的改变对心肌损害的诊断意义。方法 对2008年1月-2011年12月140例我院急诊入院的急性一氧化碳患者的临床资料进行回顾性分析，分为轻度、中度、重度中毒组。患者入院后均在12小时内行心电图检查、静脉采血查心肌酶、CTNT定量。结果 心电图的改变及心肌酶、CTNT的升高与中毒程度呈正相关，其差异有显著性，中重度中毒与轻度中毒相比，有统计学意义（Plt;0.01),重度中毒与中度中毒相比,亦有统计学意义(Plt;0.01)。经治疗，136例康复出院，在一氧化碳中毒纠正后，心电图、心肌酶、CTNC均恢复正常；3例因中毒时间长合并多脏器功能衰竭死亡；一例因高压氧治疗后急性肺水肿心衰死亡。结论 心电图改变，心肌酶、CTNT升高对急性一氧化碳中毒合并心肌损害有重要意义。 【关键词】一氧化碳中毒 心肌损伤 心肌酶 CTNT 心电图 Clinical evidence of myocardial damage after acute carbonmonoxide poisoning 【Abstract】　Objective to study electrocardiogram （ECG），serum creatase，troponin change after carbonmonoxide (CO）poisoning inducing myocardial damage.Methods.Single institution retrospective review of 140 patients diagnosed with acute CO poisoning between January 2008 and December 2011.The patients were divided into mild，moderate or severegroup.All cases were undertaken ECG examination and testing of serum creatase and troponin level at administration.Results.The change of ECG，increasing level of serum creatase，troponin has positive relationship with the degree of CO poisoning.All the three variables have significance difference among the threegroups (Plt;0.01).136 casesgot fully recover after treatment.However，3 cases died of multiple organs failure for delay administration and 1 case died of acute edema of lung resulted from hyperbaric oxygen treatment.ECG，serum creatase，troponin level returned to normal after the CO poisoning status were corrected in the survival cases.Conclusion：The combination of ECG examinaiton，serum creatase，troponin level checkup was significant to the diagnosis and prognosis of myocardial damage after acute carbonmonoxide poisoning. 【Key words】　acute carbonmonoxide poisoning myocardial damage ECG creatase troponin 急性一氧化碳中毒（ACOP）在我国北方地区冬季生活中中毒最常见的原因，也是急诊内科中最常见的急重诊之一，ACOP是人体吸入过多的CO引起的全身中毒性疾病，可造成多脏器缺氧性损伤，严重者可危及生