22例电击伤心肌酶谱的动态观察

A Developmental Observation of Myocardium Zymogram in 22 Cases of Ter Electric Injury

目的 :探讨电击伤对人体心脏的损害及心脏酶谱的变化。方法 :统计 1997年 5月至 1998年 10月 2 2例电击伤病人 (电压 2 2 0～ 3万伏 ,其中小于 1千伏 6例 ,大于或等于 1千伏 16例 ,死亡 1例 ,TBSA1 35 %Ⅲ ) ,在电击伤后 12h、2 4h、48h ,一周及四周分别抽血测定GOT、LDH、CPK及MB CPK的含量 ,并将 10名正常人的心肌酶作对照组。结果 :(1)小于 1千伏病人 48hGOT、LDH、MB CPK明显升高。第 7dLDH和MB CPK仍升高 ,至四周均降为正常。 (2 )大于或等于 1千伏病人GOT、LDH、CPK及MB CPK明显升高 ,48h达到高峰后逐渐下降 ,但至一周与正常组比较差别的有非常显著性P <0 .0 1。第四周LDH、CPK及MB CPK分别高达 430mg/L、6 80IV/L、70 0IV/L、40 0IV/L ,并居高不下。结论 :常压电流及高压电流均能对心肌产生损害 ,但高压电危害更大 ,同心肌梗塞及大面积烧伤病人比较 ,高压电击伤对心肌的损害更为持久。心肌酶居高不下 。

Objective: To explore the changes of myocardium zymogram after electric injuny. Methods: 22 cases hit by voltage 220-30000v (6 cases by voltage below 1000v, 16 cases by beyond 3000v). The GOT, LDH, CPK, and MB CPK of blood were measured at 12, 24, 48 hours and 1, 4 weeks after injury. 10 cases of normal myocardium zymogram were settled as control group. Results: (1) The levels of LDH, GOT, and MB CPK of patients who hit by voltage below 1000v went up obviously and the levels of LDH and MB CPK kept in high level for days. (2) The levels of LDH, GOT and MB CPK of patients who hit by voltage beyond 1000v went up obviously for 48 hours and then declined. There was significant differience between this group and the control group. ( P <0.01). (3) The levels of GOT, LDH, CPK, and MB CPK of the dead patient were 4.30 ng/L. 680 iv/L,700 iv/L, 400 iv/L, respectively. Conclusion: Although both normal voltage and high voltage can injure the myocardium, high voltage causes a more harm in the heart. The harm in the heart caused by high voltage lasts longer, compared with myocaediumic intraction and the large area burns. A continued high level of myocardium enzyme would indicate a bad prognosis.