急性硫化氢中毒465例心电图异常表现特点的研究

ECG Abnormality of 465 Cases with Acute Hydrogen Sulfide Poisoning

目的探讨急性硫化氢中毒病人心电图异常表现的特点及对心肌损害的预后判断。方法入院时对465例急性硫化氢中毒患者进行标准导联心电图检查。结果 465例病人中心电图异常325例,占69.89%,其中轻度、中度和重度中毒病人心电图异常的发生率分别为31.40%、88.75%和96.99%。中度和重度中毒患者心电图异常发生率明显高于轻度中毒患者(P<0.01),ST-T异常在中度和重度中毒病人中发生率分别为42.50%和48.87%,明显高于轻度中毒病人(P<0.01),重度中毒病人ST段抬高及心律失常发生率与轻度和中度中毒相比差异有统计学意义(P<0.01)。结论急性中度和重度硫化氢中毒患者的心电图异常发生率较高,心肌缺血缺氧为心电图异常表现的主要特点,重度中毒者的心肌损伤心电图表现显著增加。

Objective The characteristics of electrocardiogram manifestations of patients with acute hydrogen sulfide poisoning were studied to understand the mechanism of hydrogen sulfide poisoning on myocardial damage and judgement of prognosis. Methods 465 cases with acute hydrogen sulfide poisoning were examined with standard lead electrocardiography on admission time. Results 69.89% （325/465） of patients had abnormal ECG; the abnormal rate of ECG for the mild, moderate and severe poisoning was 31.40%, 88.75% and 96.99% respectively. The abnormal rates of ECG of moderate and severe poisoning cases were significantly higher than that of the mild poisoning eases （P 〈 0.01 ）. The incidence of ST-T abnormalities in patients with moderate and severe poisoning were 42.50% and 48.87% ,respectively,which obviously higher than patients with mild poisoning （P 〈 0.01 ）. There were significant differences in the incidence of ST segment elevation and arrhythmia in severe poisoning compared with mild and moderate poisoning （P 〈 0.01）. Conclusions There was a higher incidence of electrocardiographic abnormality in acute moderate and severe hydrogen sulfide poisoning cases with displaying mainly myocardial ischemic-anoxic. Electrocardiogram of myocardial injuries increased significantly in patients with severe intoxication.