CAJ | 학술논문

目的研究急性有机磷中毒患者不同心电图改变及对其预后的预测价值.方法入选河南省人民医院103例急性口服有机磷中毒患者,入院时及入院24 h分别行心电图检查,对比两次心电图变化特征,应用统计学方法分析不同心电图变化对其预后的预测价值.结果对入选的103例急性有机磷中毒患者临床资料进行分析发现,PR间期与急性呼吸衰竭发生率之间比较差异有统计学意义,年龄和QTc间期与死亡及急性呼吸衰竭发生率差异均有统计学意义.入院24 h后QTc均较入院时延长.血胆碱酯酶(CHE)、QTc和两次QTc之差(△QTc)对急性呼吸衰竭发生率受试者工作特征曲线(ROC)下面积分别为:0.033 (95％ CI:0.004～0.063),0.829(95％CI:0.739 ～0.918)和0.943 (95％ CI:0.888 ～0.998);CHE、QTc和△QTc对病死率ROC曲线下面积分别为:0.052(95％ CI:0.01 ～0.094),0.693 (95％ CI:0.559 ～0.826)和0.895 (95％ CI:0.814～0.977).结论 △QTc可能作为新的、更好的预测急性口服有机磷中毒患者短期预后的指标.
목적 연구급성유궤린중독환자불동심전도개변급대기예후적예측개치.방법 입선하남성인민의원103례급성구복유궤린중독환자,입원시급입원24 h분별행심전도검사,대비량차심전도변화특정,응용통계학방법분석불동심전도변화대기예후적예측개치.결과 대입선적103례급성유궤린중독환자림상자료진행분석발현,PR간기여급성호흡쇠갈발생솔지간비교차이유통계학의의,년령화QTc간기여사망급급성호흡쇠갈발생솔차이균유통계학의의.입원24 h후QTc균교입원시연장.혈담감지매(CHE)、QTc화량차QTc지차(△QTc)대급성호흡쇠갈발생솔수시자공작특정곡선(ROC)하면적분별위:0.033 (95％ CI:0.004～0.063),0.829(95％CI:0.739 ～0.918)화0.943 (95％ CI:0.888 ～0.998);CHE、QTc화△QTc대병사솔ROC곡선하면적분별위:0.052(95％ CI:0.01 ～0.094),0.693 (95％ CI:0.559 ～0.826)화0.895 (95％ CI:0.814～0.977).결론 △QTc가능작위신적、경호적예측급성구복유궤린중독환자단기예후적지표.
Objective To study the value of the different electrocardiographic changes in acute organophosphate poisoning.Methods A total of 103 patients with acute organophosphate (OP) poisoning were included and their relevant ECG abnormalities were investigated.ECG recordings were taken on arrival at the emergency department and 24 hours after admission.ECG analysis included heart rate,ST-T abnormalities,conduction defects,measurement of PR and QTc intervals,and the difference in QTc intervals between two ECG readings (△QTc).The correlation was assessed between ECG changes and the severity of poisoning.Results QTc and age were significant risk factors for respiratory failure and mortality.PR was significant risk factor for respiratory failure.The prolonged QTc interval was found in 100％ of patients 24 hours after poisoning.The area under receiver operating characteristic (ROC) curves of the blood cholinesterase activity (CHE),QTc and △QTc for respiratory failure were 0.033 (95％ CI:0.004-0.063),0.829 (95 ％ CI:0.739-0.918) and 0.943 (95％ CI:0.888-0.998) respectively.And the area under ROC curves of the CHE,QTc and △QTc for death were 0.052 (95％ CI:0.01-0.094),0.693 (95％ CI:0.559-0.826) and 0.895 (95％ CI:0.814-0.977) respectively.Conclusions The△QTc may be a novel and better predictive factor for determining short-term prognosis after intentional organophosphate poisoning.