中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2012年
6期
452-455
,共4页
万伟国%姜莉%郑舒聪%裘昊旻%宣丹旦%邹和建
萬偉國%薑莉%鄭舒聰%裘昊旻%宣丹旦%鄒和建
만위국%강리%정서총%구호민%선단단%추화건
有机磷%中毒%心肌酶%肌钙蛋白
有機燐%中毒%心肌酶%肌鈣蛋白
유궤린%중독%심기매%기개단백
Organophosphorous%Poisoning%Cardiac enzyme%Troponin
目的 探讨心肌酶及肌钙蛋白在急性有机磷农药中毒心肌损害诊断中的价值.方法 检索国内1979至2010年学术期刊及PubMed上发表的急性有机磷农药中毒并且有心肌酶及肌钙蛋白研究的文献,进行统计和分析.纳入有机磷农药中毒患者病例数2129例.结果 与对照组比较,轻、中、重度中毒组血清肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)活力和肌钙蛋白(cTnI)水平均明显增高,差异有统计学意义(P<0.05);各中毒组血清CK和CK-MB活力和cTnI水平的差异有统计学意义(P<0.05);中、重度中毒组CK-MB/CK明显低于对照组,差异有统计学意义(P<0.05).中间期肌无力综合征( IMS)组血清CK、CK-MB活力和cTnI水平均明显高于非IMS组,差异有统计学意义(P<0.05).与非呼吸肌麻痹重度中毒组比较,呼吸肌麻痹组血清CK、CK-MB活力均明显增高,CK-MB/CK的比值明显降低,差异有统计学意义(P<0.05).结论 单纯血清CK、CK-MB活力升高作为有机磷农药中毒患者心肌损害的诊断依据不足,CK-MB/CK的比值的诊断价值更高;cTnI水平作为诊断有机磷农药中毒患者心肌损害的依据值得怀疑.CK、CK-MB活力及cTnI水平可作为有机磷农药中毒病情轻重的辅助判断依据.
目的 探討心肌酶及肌鈣蛋白在急性有機燐農藥中毒心肌損害診斷中的價值.方法 檢索國內1979至2010年學術期刊及PubMed上髮錶的急性有機燐農藥中毒併且有心肌酶及肌鈣蛋白研究的文獻,進行統計和分析.納入有機燐農藥中毒患者病例數2129例.結果 與對照組比較,輕、中、重度中毒組血清肌痠激酶(CK)和肌痠激酶同工酶(CK-MB)活力和肌鈣蛋白(cTnI)水平均明顯增高,差異有統計學意義(P<0.05);各中毒組血清CK和CK-MB活力和cTnI水平的差異有統計學意義(P<0.05);中、重度中毒組CK-MB/CK明顯低于對照組,差異有統計學意義(P<0.05).中間期肌無力綜閤徵( IMS)組血清CK、CK-MB活力和cTnI水平均明顯高于非IMS組,差異有統計學意義(P<0.05).與非呼吸肌痳痺重度中毒組比較,呼吸肌痳痺組血清CK、CK-MB活力均明顯增高,CK-MB/CK的比值明顯降低,差異有統計學意義(P<0.05).結論 單純血清CK、CK-MB活力升高作為有機燐農藥中毒患者心肌損害的診斷依據不足,CK-MB/CK的比值的診斷價值更高;cTnI水平作為診斷有機燐農藥中毒患者心肌損害的依據值得懷疑.CK、CK-MB活力及cTnI水平可作為有機燐農藥中毒病情輕重的輔助判斷依據.
목적 탐토심기매급기개단백재급성유궤린농약중독심기손해진단중적개치.방법 검색국내1979지2010년학술기간급PubMed상발표적급성유궤린농약중독병차유심기매급기개단백연구적문헌,진행통계화분석.납입유궤린농약중독환자병례수2129례.결과 여대조조비교,경、중、중도중독조혈청기산격매(CK)화기산격매동공매(CK-MB)활력화기개단백(cTnI)수평균명현증고,차이유통계학의의(P<0.05);각중독조혈청CK화CK-MB활력화cTnI수평적차이유통계학의의(P<0.05);중、중도중독조CK-MB/CK명현저우대조조,차이유통계학의의(P<0.05).중간기기무력종합정( IMS)조혈청CK、CK-MB활력화cTnI수평균명현고우비IMS조,차이유통계학의의(P<0.05).여비호흡기마비중도중독조비교,호흡기마비조혈청CK、CK-MB활력균명현증고,CK-MB/CK적비치명현강저,차이유통계학의의(P<0.05).결론 단순혈청CK、CK-MB활력승고작위유궤린농약중독환자심기손해적진단의거불족,CK-MB/CK적비치적진단개치경고;cTnI수평작위진단유궤린농약중독환자심기손해적의거치득부의.CK、CK-MB활력급cTnI수평가작위유궤린농약중독병정경중적보조판단의거.
Objective To discuss the diagnostic value of cardiac enzyme and troponin in acute organophosphorus pesticide poisoning(AOPP).Methods A retrospective study was performed in the document published in domestic journals and PubMed from 1979 to 2010.The data of the cardiac enzyme and troponin were collected.Statistical analysis was conducted with one-way ANOVA and rank sum test.2129 cases with AOPP were enrolled.Results The levels of creatine kinase (CK),creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) in milder,moderate and severe poisoning groups were significantly elevated compared by the healthy control group (P<0.05).The differences were also dramatic among three patients groups (P<0.05).The ratios of CK-MB to CK in both moderate and severe groups were significantly lower than in healthy controls (P<0.05).The levels of CK,CK-MB and cTnI were higher especially in patients with intermediate myasthenics syndrome (IMS) than patients without IMS.Meanwhile,the levels of CK and CK-MB were elevated in patients with respiratory failure compared by non-failure ones,but decreased in the ratios of CK-MB to CK (P<0.05).Conclusions The elevation of CK and CK-MB in serum could not be judged as the criteria of myocardial damage in AOPP,the ratio of CK-MB to CK were more valuable:the value of cTnI in myocardial damage was still in suspect.CK 、CK-MB and cTnI could be used as auxiliary criteria of AOPP classification.