肌钙蛋白Ⅰ测定在急性亚硝酸盐中毒监测中的临床意义

Clinical significance of serum cardiac troponin Ⅰ in acute nitrite poisoning

目的观察急性亚硝酸盐中毒患者肌钙蛋白Ⅰ的变化,分析其与疾病程度和预后的关系。方法132例急性亚硝酸盐中毒患者,均于发病后3 h内进入急诊抢救室治疗。于入院后3和24 h测定肌钙蛋白Ⅰ。将患者分为肌钙蛋白Ⅰ正常组(A组)和肌钙蛋白Ⅰ升高组(B组),比较两组患者急性生理与慢性健康状况评分(APACHE)Ⅱ、脏器衰竭率和病死率。结果B组APACHEⅡ评分为(20±7)分,明显高于A组的(11±3)分(P＜0．05)。B组脏器衰竭率和病死率分别为20．0%和12．9%,均明显高于A组的0%和0%(P值均＜0．01)。结论急性亚硝酸盐中毒患者中肌钙蛋白Ⅰ升高者的APACHEⅡ评分高、预后差。肌钙蛋白Ⅰ测定可作为急性亚硝酸盐中毒预后监测的一项可靠指标。

Objective To detect the changes of the serum cardiac troponin Ⅰ （cTnI） in acute nitrite poisoning and analyze the relationship between serum cTnI level and the degree of severity together with the prognosis. Methods The serum cTnI level was measured in 132 cases of acute nitrite poisoning patients on the 3rd and 24th hour after hospitalization. The patients were divided into group A with normal serum cTnI and group B with high serum cTnI levels. Comparing the acute physiologic and chronic health evaluations（APACHE） Ⅱ, the organic failure rates and mortality rates between the two groups. Results The organic failure rate and mortality rate were significantly higher in group B than those in group A. The APACHE Ⅱ scoring was significantly higher in group A than that of group B. Conclusion There is a positive correlationships between the serum cTnI level and APACHE Ⅱ, of which the serum cTnI level can be taken as a reliable monitoring prognostic factor in acute nitrite intoxication patients. （Shanghai Med J, 2006, 29：653 655）