有机磷农药急性中毒心脏损害的诊治

The Diagnosis and Treatment of Cardiac Lesion from Acute Organophosphorous Insecticides Poisoning(AOPP) with the Severity of Poisoning

目的研究急性有机磷农药中毒(A0PP)患者心肌损害情况的诊断及其与中毒程度的关系,并探讨其治疗经验。方法85例记录心电图,轻、中度组中毒后3d内查血清心肌酶谱1次,重度组连续心电监护,并分别于中毒后第1、3、5、7天抽血查心肌酶谱。对照组抽血查心肌酶谱1次。除按有机磷农药中毒处理外,早期针对心脏损害进行治疗。结果心肌酶谱于中毒后逐渐升高,并随中毒程度加重而升高,中、重度组与对照组比较均具有显著性差异(P<0.01)。心电图异常中重度组18例,中度组9例,轻度组4例,各组间比较有显著性差异(P<0.05)。结论(1)监测心肌酶谱及心电图对及时诊断AOPP中毒性心肌损伤有重要的临床意义;(2)A0PP心肌酶升高与中毒严重程度有关,并随病情缓解呈恢复趋势;(3)早期针对心脏损害发生的不同机制采取不同的治疗对策。

Objective To study the relation of cardiac lesion from acute organophosphorous insecticides poisoning（AOPP） with the severity of poisoning and to explore experience of the treatment. Methods 85 patients were recorded with the electrocardiogram. The human serum cardiac enzyme serie were measured in light group and middle group after three days, and recorded with the human serum cardiac enzyme serie in severe group after one day, three days, five days and seven days. Normal control group were observed the human serum cardiac enzyme serie once.Beside to manage AOPP,we early use of protective myocardial treatment during cardiac lesion. Results We found the level of the human serum cardiac enzyme serie was higher and had a correlation with intoxication level. Middle group and severe group were higher than normal control group（P 〈 0.01 ）. The abnormity of ECG in various group has 18 cases,in middle group has 9 case and in light group has 4 cases. There are obviously different among three groups（P 〈 0.05）. Conclusion （1）The detection of the human serum cardiac enzyme serie and the ECG has clinical significance to diagnosis the cardiac lesion from AOPP in time. （2）The level of the human serum cardiac enzyme serie has a correlation with intoxication level and the level of the human serum cardiac enzyme serie is recovery trendency with Patients condition improvement. （3）We should early use of protective myocardial treatment during cardiac lesion.