cTnI诊断轻中度急性一氧化碳中毒患者心肌损伤的研究

Stud of cTnI on diagnosis of myocardial injury in mild and moderate acute carbon monoxide poisoning

目的探讨心肌肌钙蛋白I(cTnI)在急性一氧化碳中毒(ACOP)患者心肌损伤诊断中的意义。方法30例我院1999年1月￣2004年1月轻度(n=14)及中度(n=16)ACOP患者,检测接诊后0h,8h,1d,3d及7d时血清cTnI水平、心肌酶学及心电图,比较cTnI和其他单项或综合指标对轻度及中度ACOP患者心肌损伤检出率的差异。结果中度中毒组cTnI升高例数显著高于轻度中毒组(P<0.01),而其他各单项指标异常例数的差异无显著性(P>0.05)。两组间心肌酶学升高或心电图异常例数的差异无显著性(P>0.05);综合心肌酶学及心电图检查结果后,中度中毒组检出率例数显著高于轻度中毒组(P<0.05)。并且cTnI升高的例数显著高于其他单一或综合指标异常的例数(P<0.05)。结论应用血清cTnI的检测能明显提高ACOP患者心肌损伤的检出率,其灵敏度明显优于心肌酶学及心电图检查。

To study the value of cardiac troponin I (cTnI) in the diagnosis of myocardial injury in acut carbon monoxide poisoning (ACOP) patients. Thirty cases of ACOP patients, diagnosed as mild ACOP (n =14) and moderate ACOP (n =16), were studied on the serum cTnI, myocardial zymogram and electrocardiogram at 0 h, 8 h, 1 d, 3 d and 7 d after the emergency acceptance. And also, the abnormalities of single and combined items between the two groups were analyzed. the rate of elevated serum cTnI patients in moderate ACOP group was significantly higher than that in mild ACOP group (P <0.01), but no statistical differences showed between the others in the two group (P >0.05); the abnormal rates of myocardial zymogram or electrocardiogram had no significant difference between the two groups (P >0.05), but when combining the myocardial zymogram and electrocardiogram results, the abnormal rate of the moderate ACOP group was significantly higher than that of the mild ACOP group (P <0.05). Moreover, the rate of abnormal cTnI was significantly higher than that of any other or combined items. (P <0.01). [Conclusions] The appliance of serum cTnI can effectively enhance the detective rate of myocardial injury in ACOP patients, which will be more sensitive than myocardial zymogram and electrocardiogram.