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目的探讨血清肌钙蛋白Ⅰ(cTnI)测定在诊断急性有机磷中毒(AOPP)患者心肌损伤时的应用价值及意义。方法不同程度AOPP患者52例,按中毒的严重程度分为轻、中、重度中毒组,于中毒第1、2、3、5、7天,测定血清cTnI、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、乳酸脱氢酶(LDH)的含量,根据AOPP后心肌酶谱达峰值的第三天对上述项目进行比较分析,同时以cTnI与心肌酶谱各参数大于正常对照2s为阳性,进行阳性率的比较。结果AOPP患者血清cTnI在中毒后第二天达高峰,第三天,不同程度中毒患者血清cTnI和心肌酶谱值随病情严重而增加,第七天仍明显高于对照组(P<0.01)。cTnI敏感度高于CK、CKMB及LDH,其阳性率依次为96.2%和78.8%、84.6%、76.9%(P<0.01或P<0.05)。结论血清cTnI对有机磷农药中毒心肌损伤的诊断敏感性高,比心肌酶谱更有价值。
Objective To investigate the value and significance of serum troponin Ⅰ (cTnI) in the diagnosis of myocardial injury in patients with acute organophosphorus poisoning (AOPP). Methods Fifty-two patients with AOPP were divided into mild, moderate and severe poisoning groups according to the severity of poisoning. The levels of cTnI, creatine kinase (CK) and creatine CKMB and LDH, the third day after the peak of myocardial enzyme spectrum of AOPP, the above items were compared and analyzed, and the parameters of cTnI and myocardial enzymes were bigger than the normal control 2s Positive, positive rate comparison. Results Serum cTnI of AOPP patients peaked on the second day after poisoning. On the third day, levels of serum cTnI and myocardial enzymes of patients with different degrees of poisoning increased with the severity of the illness, and remained significantly higher on the seventh day than that of the control group (P <0.01). The positive rates of cTnI were higher than those of CK, CKMB and LDH. The positive rates of cTnI were 96.2% and 78.8%, 84.6% and 76.9%, respectively (P <0.01 or P <0.05). Conclusion Serum cTnI is highly sensitive to the diagnosis of myocardial damage caused by organophosphorus pesticide poisoning and more valuable than the myocardial enzyme spectrum.