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目的:分析毒鼠强致中毒性心肌病的临床表现,总结救治经验。方法:总结分析46例毒鼠强致中毒性心肌病患者的临床表现,心肌酶学变化,血清心肌肌钙蛋白(cTnT)变化,心电图演变,治疗经验及转归。结果:46例中,发生中毒后1天出现心肌损害6例,占13%;3天出现30例,占65%;5天出现10例,占21.7%;休克6例,占13%,CK及CK-MB升高46例,占100%。cTnT升高46例(正常2倍以上)占100%。心电图窦性心动过缓25例,占54.3%;窦性心动过速7例,占15.2%;心肌缺血表现16例,占34.7%,左前分支阻滞和非阵发性交界性心律各1例。10天恢复14例,占30.4%;15天恢复15例,占10.8%;21天恢复6例,占13%;30天恢复14例,占45.6%。结论:毒鼠强致中毒性心肌损害3天后出现最多,窦性心动过缓发生率最高,患者均有cTnT、CK及CK-MB升高。
Objective: To analyze the clinical manifestations of tetramine poisoning caused by tetramine poisoning and to sum up the experience of treatment. Methods: The clinical manifestations, myocardial enzymology changes, serum cardiac troponin (cTnT) changes, electrocardiogram changes, treatment experience and prognosis of 46 patients with toxic poisoning cardiomyopathy were summarized. Results: Among the 46 cases, myocardial damage occurred in 6 cases (13%) one day after poisoning, 30 cases (65%) in 3 days, 10 cases (21.7%) in 5 days and 6% (13%) in shock And CK-MB increased 46 cases, accounting for 100%. 46 cases of cTnT increased (more than 2 times normal) accounted for 100%. Electrocardiographic sinus bradycardia in 25 cases, accounting for 54.3%; sinus tachycardia in 7 cases, accounting for 15.2%; myocardial ischemia in 16 cases, 34.7%, left anterior branch block and non-paroxysmal border rhythm of the 1 example. In 10 days, 14 cases recovered, accounting for 30.4%; 15 cases recovered in 15 days, accounting for 10.8%; 6 cases recovered in 21 days, accounting for 13%; 14 cases recovered in 30 days, accounting for 45.6%. CONCLUSION: The most toxic myocardial damage caused by tetramine poisoning occurs most frequently after 3 days. The incidence of sinus bradycardia is the highest. The patients have elevated cTnT, CK and CK-MB.