CAJ | 학술논문

目的：探讨急性有机磷农药中毒(AOPP)6 h后心肌损伤最佳标志物。方法选取2006年5月~2014年11月就诊于首都医科大学电力教学医院(以下简称“我院”)急诊科的86例AOPP患者作为观察组，按《职业性急性有机磷杀虫剂中毒诊断标准》(GBZ8-2002)分成轻度、中度和重度中毒3组。所有患者常规行12导联心电图检查，均于服毒后6 h检测肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)。对照组来源于我院门诊健康体检者，体检当天检测CK、CK-MB、cTnI。观察各组上述3项指标。结果观察组与对照组CK、CK-MB、cTnI水平比较差异有统计学意义(P<0.05)。轻度中毒组与对照组CK、CK-MB水平比较差异无统计学意义(P>0.05)，cTnI水平差异有统计学意义(P<0.05)；中度及重度中毒组与对照组CK、CK-MB、cTnI水平比较差异有统计学意义(P<0.05)。中度及重度中毒组与轻度中毒组CK、CK-MB水平比较差异有统计学意义(P<0.05)，cTnI水平差异有高度统计学意义(P<0.01)。重度中毒组与中度中毒组CK水平比较差异无统计学意义(P>0.05)，CK-MB水平差异有统计学意义(P<0.05)，cTnI水平差异有高度统计学意义(P<0.01)。结论cTnI是判断AOPP心肌损伤的最敏感指标，是AOPP心肌损伤的最佳标志物，CK-MB次之。 CK和心电图对判断AOPP心肌损伤及损伤程度价值不大。
목적：탐토급성유궤린농약중독(AOPP)6 h후심기손상최가표지물。방법선취2006년5월~2014년11월취진우수도의과대학전력교학의원(이하간칭“아원”)급진과적86례AOPP환자작위관찰조，안《직업성급성유궤린살충제중독진단표준》(GBZ8-2002)분성경도、중도화중도중독3조。소유환자상규행12도련심전도검사，균우복독후6 h검측기산격매(CK)、기산격매동공매(CK-MB)、심기기개단백I(cTnI)。대조조래원우아원문진건강체검자，체검당천검측CK、CK-MB、cTnI。관찰각조상술3항지표。결과관찰조여대조조CK、CK-MB、cTnI수평비교차이유통계학의의(P<0.05)。경도중독조여대조조CK、CK-MB수평비교차이무통계학의의(P>0.05)，cTnI수평차이유통계학의의(P<0.05)；중도급중도중독조여대조조CK、CK-MB、cTnI수평비교차이유통계학의의(P<0.05)。중도급중도중독조여경도중독조CK、CK-MB수평비교차이유통계학의의(P<0.05)，cTnI수평차이유고도통계학의의(P<0.01)。중도중독조여중도중독조CK수평비교차이무통계학의의(P>0.05)，CK-MB수평차이유통계학의의(P<0.05)，cTnI수평차이유고도통계학의의(P<0.01)。결론cTnI시판단AOPP심기손상적최민감지표，시AOPP심기손상적최가표지물，CK-MB차지。 CK화심전도대판단AOPP심기손상급손상정도개치불대。
Objective To explore the best marker for myocardial injury after 6 hours of acute organophosphorus pesti-cide poisoning (AOPP). Methods 86 cases of AOPP patients in Department of Emergency, Electric Power Teaching Hospital of Capital Medical University ("our hospital"for short) from May 2006 to November 2014 were selected as ob-servation group. They were divided into mild poisoning group, moderate poisoning group and severe poisoning group ac-cording to the Occupational Acute Organophosphorus Pesticide Poisoning (GBZ8-2002). All patients were routinely done for 12 lead ECG examination and examined for CK, CK-MB, cTnI in 6 hours after taking poison. Control group was from our hospital outpatient health examination, and CK, CK-MB, cTnI levels were examined the same day. The above three indicators of each group were observed. Results There were statistical differences in CK, CK-MB, cTnI levels between observation group and control group (P < 0.05). There were no statistical differences in CK, CK-MB levels between mild poisoning group and control group (P>0.05), and there was statistical difference in cTnI level be-tween mild poisoning group and control group (P<0.05). There were statistical differences in CK, CK-MB, cTnI levels between moderate poisoning group and control group, severe poisoning group and control group (P<0.05). There were statistical differences in CK, CK-MB levels between moderate poisoning group and mild poisoning group, severe poi-soning group and mild poisoning group (P< 0.05). There was significantly statistical difference in cTnI level between moderate poisoning group and mild poisoning group, severe poisoning group and mild poisoning group (P<0.01). There was no statistical difference in CK level between severe poisoning group and moderate poisoning group (P > 0.05). There was statistical difference in CK-MB level between severe poisoning group and moderate poisoning group (P<0.05). There was significantly statistical difference in cTnI level between severe poisoning group and moderate poison-ing group (P<0.01). Conclusion cTnI is the most sensitive index of AOPP, and is the best marker for AOPP myocar-dial damage, CK-MB times. The value of CK and ECG in the injury of AOPP is not.