CAJ | 학술논문

目的探讨儿茶酚胺在急性有机磷农药中毒可导致心肌损害中的作用.方法收集2008年1月至2009年12月就诊于北京朝阳医院急诊科的急性敌敌畏中毒患者.根据入选标准,41例入选,进入急诊监护室接受阿托品和氯解磷定等规范治疗,检测入院第1、3、5天和出院前血清CK-MB、CTNI、胆碱酯酶、乙酰胆碱和肾上腺素和去甲肾上腺素；隔日ECG检查；出院随访3月.结果 37例存活,4例死亡；窦性心动过速37例,28例ST-T改变；CK-MB和CTNI先升高,第3天达到峰值,后逐渐降至正常；胆碱酯酶入院时最低,后逐渐恢复至正常值.血清乙酰胆碱第1天达峰值然后下降,肾上腺素和去甲肾上腺素从第1天最高值至出院前下降至正常.结论重度急性敌敌畏中毒可导致心脏损伤,儿茶酚胺分泌增加可能是重要原因之一.
목적 탐토인다분알재급성유궤린농약중독가도치심기손해중적작용.방법 수집2008년1월지2009년12월취진우북경조양의원급진과적급성활활외중독환자.근거입선표준,41례입선,진입급진감호실접수아탁품화록해린정등규범치료,검측입원제1、3、5천화출원전혈청CK-MB、CTNI、담감지매、을선담감화신상선소화거갑신상선소；격일ECG검사；출원수방3월.결과 37례존활,4례사망；두성심동과속37례,28례ST-T개변；CK-MB화CTNI선승고,제3천체도봉치,후축점강지정상；담감지매입원시최저,후축점회복지정상치.혈청을선담감제1천체봉치연후하강,신상선소화거갑신상선소종제1천최고치지출원전하강지정상.결론 중도급성활활외중독가도치심장손상,인다분알분비증가가능시중요원인지일.
Objective To study the role of catecholamine in genesis of myocardium injury after organophosphorus poisoning (OP) in order to elucidate the underlying mechanisms of OP-induced cardiotoxicity.Methods Of 92 patients with severe acute dichlorvos poisoning,41 were consecutively enrolled for study and followed up for three months. The levels of serum creatine kinase isoenzyme myocardium (CK-MB),cardiac troponin Ⅰ (cTnI),acetylcholinesterase (AChE),acetylcholine (Ach),epinephrine and norepinephrine were assayed on the 1st,3rd and 5th days after admission and on the day of discharge.Electrocardiography was recorded every day after admission.Results Of them,37 (90.2％ )patients survived and four ( 9.8％ ) patients died during treatment.Sinus tachycardia was found in 37 (90.2％ ) patients and ST-T changes in 33 (80.4％ ) patients.CK-MB and cTnI levels peaked 3 days after admission,and then decreased to normal levels.Serum Ach,epinephrine and norepinephrine peaked on the 1st day after admission and then decreased.Conclusions Severe acute dichlorvos poisoning is associated with myocardial dysfunction likely caused by increase in catecholamine levels.