中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
3期
1-4
,共4页
李敬%孔繁托%刘晓婷%田春辉%张建军%王岚%王维展
李敬%孔繁託%劉曉婷%田春輝%張建軍%王嵐%王維展
리경%공번탁%류효정%전춘휘%장건군%왕람%왕유전
一氧化碳中毒%预后%缺血修饰白蛋白%和肽素
一氧化碳中毒%預後%缺血脩飾白蛋白%和肽素
일양화탄중독%예후%결혈수식백단백%화태소
Carbon monoxide poisoning%Prognosis%Ischemia modified albumin%Copeptin
目的 研究和肽素、缺血修饰白蛋白(IMA)与急性一氧化碳中毒(ACOP)心肌损伤的关系.方法 选择不同中毒程度ACOP患者110例作为中毒组,其中轻度中毒22例(轻度中毒组),中度中毒50例(中度中毒组),重度中毒38例(重度中毒组),同期健康体检者30例作为对照组,中毒组在入院后2h、7d抽取静脉血3ml,对照组在体检时抽取静脉血3ml,检测心肌肌钙蛋白Ⅰ(cTnⅠ)、IMA、和肽素水平.中毒组依据有无出现并发症,分为并发症组26例,非并发症组84例.比较各组cTnⅠ、IMA、和肽素水平的差异.结果 入院后2h,轻度、中度、重度中毒组IMA降低[(62.50 ±2.17)、(59.04±3.10)、(56.01±8.85) kU/L]、和肽素升高[(2.82±0.73)、(7.31±0.95)、(13.08±1.96) μg/L],与对照组[(67.23±1.40) kU/L和(0.87±0.19)μg/L]比较差异有统计学意义(P＜0.05),而且中度中毒组与轻度中毒组、重度中毒组与轻度中毒组和中度中毒组比较差异均有统计学意义(P＜0.05);各组cTnⅠ比较差异无统计学意义(P＞0.05).入院后7d,各组IMA、和肽素比较差异无统计学意义(P＞0.05);轻度、中度、重度中毒组cTnⅠ升高[(1.80±0.17)、(2.34±0.46)、(2.60±0.54) μg/L],与对照组[(1.27±0.28)μg/L]比较差异有统计学意义(P＜0.05),而且中度中毒组与轻度中毒组、重度中毒组与轻度中毒组和中度中毒组比较差异均有统计学意义(P＜0.05).并发症组入院后2h和入院后7dIMA、和肽素水平均高于非并发症组[(54.62±1.53) kU/L比(57.89±4.02) kU/L、(60.65±3.61) kU/L比(66.84±1.78) kU/L和(13.88±1.45) μg/L比(6.99±3.39)μg/L、(6.65±1.82) μg/L比(2.47±0.61)μg/L],差异有统计学意义(P＜0.05).并发症组入院后7 dcTnⅠ水平明显高于非并发症组[(3.10±0.22) μg/L比(1.87±0.27)μg/L],差异有统计学意义(P＜0.05).相关分析提示不同程度的ACOP患者早期和肽素水平与IMA水平呈负相关(r=-0.560,P＜0.01).结论 检测IMA和和肽素对ACOP心肌损伤早期诊断、判断预后转归及指导临床合理用药具有重要意义.
目的 研究和肽素、缺血脩飾白蛋白(IMA)與急性一氧化碳中毒(ACOP)心肌損傷的關繫.方法 選擇不同中毒程度ACOP患者110例作為中毒組,其中輕度中毒22例(輕度中毒組),中度中毒50例(中度中毒組),重度中毒38例(重度中毒組),同期健康體檢者30例作為對照組,中毒組在入院後2h、7d抽取靜脈血3ml,對照組在體檢時抽取靜脈血3ml,檢測心肌肌鈣蛋白Ⅰ(cTnⅠ)、IMA、和肽素水平.中毒組依據有無齣現併髮癥,分為併髮癥組26例,非併髮癥組84例.比較各組cTnⅠ、IMA、和肽素水平的差異.結果 入院後2h,輕度、中度、重度中毒組IMA降低[(62.50 ±2.17)、(59.04±3.10)、(56.01±8.85) kU/L]、和肽素升高[(2.82±0.73)、(7.31±0.95)、(13.08±1.96) μg/L],與對照組[(67.23±1.40) kU/L和(0.87±0.19)μg/L]比較差異有統計學意義(P＜0.05),而且中度中毒組與輕度中毒組、重度中毒組與輕度中毒組和中度中毒組比較差異均有統計學意義(P＜0.05);各組cTnⅠ比較差異無統計學意義(P＞0.05).入院後7d,各組IMA、和肽素比較差異無統計學意義(P＞0.05);輕度、中度、重度中毒組cTnⅠ升高[(1.80±0.17)、(2.34±0.46)、(2.60±0.54) μg/L],與對照組[(1.27±0.28)μg/L]比較差異有統計學意義(P＜0.05),而且中度中毒組與輕度中毒組、重度中毒組與輕度中毒組和中度中毒組比較差異均有統計學意義(P＜0.05).併髮癥組入院後2h和入院後7dIMA、和肽素水平均高于非併髮癥組[(54.62±1.53) kU/L比(57.89±4.02) kU/L、(60.65±3.61) kU/L比(66.84±1.78) kU/L和(13.88±1.45) μg/L比(6.99±3.39)μg/L、(6.65±1.82) μg/L比(2.47±0.61)μg/L],差異有統計學意義(P＜0.05).併髮癥組入院後7 dcTnⅠ水平明顯高于非併髮癥組[(3.10±0.22) μg/L比(1.87±0.27)μg/L],差異有統計學意義(P＜0.05).相關分析提示不同程度的ACOP患者早期和肽素水平與IMA水平呈負相關(r=-0.560,P＜0.01).結論 檢測IMA和和肽素對ACOP心肌損傷早期診斷、判斷預後轉歸及指導臨床閤理用藥具有重要意義.
목적 연구화태소、결혈수식백단백(IMA)여급성일양화탄중독(ACOP)심기손상적관계.방법 선택불동중독정도ACOP환자110례작위중독조,기중경도중독22례(경도중독조),중도중독50례(중도중독조),중도중독38례(중도중독조),동기건강체검자30례작위대조조,중독조재입원후2h、7d추취정맥혈3ml,대조조재체검시추취정맥혈3ml,검측심기기개단백Ⅰ(cTnⅠ)、IMA、화태소수평.중독조의거유무출현병발증,분위병발증조26례,비병발증조84례.비교각조cTnⅠ、IMA、화태소수평적차이.결과 입원후2h,경도、중도、중도중독조IMA강저[(62.50 ±2.17)、(59.04±3.10)、(56.01±8.85) kU/L]、화태소승고[(2.82±0.73)、(7.31±0.95)、(13.08±1.96) μg/L],여대조조[(67.23±1.40) kU/L화(0.87±0.19)μg/L]비교차이유통계학의의(P＜0.05),이차중도중독조여경도중독조、중도중독조여경도중독조화중도중독조비교차이균유통계학의의(P＜0.05);각조cTnⅠ비교차이무통계학의의(P＞0.05).입원후7d,각조IMA、화태소비교차이무통계학의의(P＞0.05);경도、중도、중도중독조cTnⅠ승고[(1.80±0.17)、(2.34±0.46)、(2.60±0.54) μg/L],여대조조[(1.27±0.28)μg/L]비교차이유통계학의의(P＜0.05),이차중도중독조여경도중독조、중도중독조여경도중독조화중도중독조비교차이균유통계학의의(P＜0.05).병발증조입원후2h화입원후7dIMA、화태소수평균고우비병발증조[(54.62±1.53) kU/L비(57.89±4.02) kU/L、(60.65±3.61) kU/L비(66.84±1.78) kU/L화(13.88±1.45) μg/L비(6.99±3.39)μg/L、(6.65±1.82) μg/L비(2.47±0.61)μg/L],차이유통계학의의(P＜0.05).병발증조입원후7 dcTnⅠ수평명현고우비병발증조[(3.10±0.22) μg/L비(1.87±0.27)μg/L],차이유통계학의의(P＜0.05).상관분석제시불동정도적ACOP환자조기화태소수평여IMA수평정부상관(r=-0.560,P＜0.01).결론 검측IMA화화태소대ACOP심기손상조기진단、판단예후전귀급지도림상합리용약구유중요의의.
Objective To study the relationship between copeptin,ischemia modified albumin (IMA) and the degree of myocardial injury in patients with acute carbon monoxide poisoning (ACOP).Methods A total of 110 ACOP patients with different degree of poisoning were selected as poisoning group and included mild poisoning 22 cases (mild group),moderate poisoning 50 cases (moderate group),severe poisoning 38 cases (severe group),and 30 healthy subjects were selected as control group.The cardiac troponin Ⅰ (cTnⅠ),IMA,copeptin level was detected at 2 h,7 d after admission in poisoning group and at admission in control group.According to with or without complications,poisoning group was divided into complications group (26 cases) and non-complications group (84 cases).cTnⅠ,IMA,copeptin level was compared among groups.Results At 2 h after admission,IMA was decreased and copeptin was increased in mild,moderate,severe group[(62.50 ± 2.17),(59.04 ± 3.10),(56.01 ± 8.85) kU/L and (2.82 ± 0.73),(7.31 ±0.95),(13.08 ± 1.96) μg/L],there was statistical difference compared with control group [(67.23 ± 1.40) kU/L and (0.87 ±0.19) μg/L](P＜0.05),and there was significant difference between moderate group and mild group,severe group and mild group,moderate group (P ＜ 0.05);there was no statistical difference in cTnⅠ among groups.At 7 d after admission,there was no significant difference in IMA,copeptin among groups (P ＞ 0.05) ; cTnⅠ was increased in mild,moderate,severe group [(1.80 ± 0.17),(2.34 ±0.46),(2.60 ±0.54) μg/L],and there was statistical difference compared with control group [(1.27 ±0.28) μg/L] (P ＜0.05),and there was significant difference between moderate group and mild group,severe group and mild group,moderate group (P＜ 0.05).IMA,copeptin at 2 h,7 d after admission in complications group was higher than that in non-complications group [(54.62 ± 1.53) kU/L vs.(57.89 ± 4.02) kU/L,(60.65 ± 3.61) kU/L vs.(66.84 ± 1.78) kU/L and (13.88 ± 1.45) μ g/L vs.(6.99 ± 3.39) μ g/L,(6.65 ± 1.82) μ g/L vs.(2.47 ± 0.61) μ g/L](P＜ 0.05).cTnⅠ at 7 d after admission in complications group was higher than that in non-complications group [(3.10 ± 0.22) μ g/L vs.(1.87 ± 0.27) μ g/L] (P ＜ 0.05).Correlation analysis showed that copeptin was negatively correlated with IMA in patients with different degree of poisoning (r =-0.560,P ＜ 0.01).Conclusions The combined detection of IMA and copeptin has important clinical value to the early diagnosis and prognosis in evaluating the prognosis of ACOP myocardial injury.There is important guidance for early clinical drug application.
