心肌酶和肌钙蛋白Ⅰ测定与急性一氧化碳中毒患者心肌损伤的关系

The Correlation between the Determination of Myocardial Enzyme & Troponin Ⅰ and Myocardial Injury Resulting from Acute Carbon Monoxide Poisoning

目的:探讨心肌酶(CK、CK～MB、LDH、HBDH)、心肌肌钙蛋白Ⅰ(cTnI)在急性一氧化碳中毒(ACOP)患者心肌损伤的临床意义。方法:选取2005年1月～2007年12月在我科住院的急性一氧化碳中毒患者98名。按照中毒程度分为轻、中、重三组。取同一时期60例健康体检者作为对照。患者入院后24h内抽取静脉血测定血清心肌酶和cTnI水平,比较它们与对照组与中毒组及急性一氧化碳中毒的轻、中、重组的差异。结果:和对照组及轻度中毒组比较中、重度中毒组心肌酶和cTnI水平明显升高,有显著性差异(P<0.01)。结论:急性一氧化碳中毒患者血清心肌酶和肌钙蛋白Ⅰ随中毒程度加深而显著升高,它们可作为ACOP的常规检查,并对评判心肌受损程度及提高治愈率、降低病死率有着重要意义。

Objective ：To investigate the clinical significance of myocardial enzyme （ CK, CK - MB, LDH, HBDH ）, cardiac troponin I （cTn I） in myocardial injury from acute carbon monoxide poisoning （ACOP）. Methods： To divide 98 cases of acute carbon monoxide poisoning from January, 2005 to December, 2007 in my division in accordance with the degree of intoxication into three groups of light, medium and heavy ones. To select 60 patients during the same period as the healthy control group. To test blood serum taken from myocardial enzymes and cTn I level for the patients admitted to hospital within 24 hours, to compare differences among three groups of poisoning from carbon monoxide with the control group. Results： cTn I and myocardial enzyme level increased significantly in control group and light intoxication group compared with medium and heavy ones （P 〈 0. 01 ）. Conclusion： Myocardial enzyme and cardiac troponin I significantly increase when the poisoning of carbon monoxide deepens. They can be used as regular test for ACOP. There is a great significance for evaluating myocardial damage, improving cure rate and reducing the mortality.