脑钠肽前体及肌钙蛋白Ⅰ在老年急性有机磷中毒心肌损伤中的价值

The value of brain natriuretic peptide and troponin Ⅰ of elderly patients with acute organophosphate poisoning

目的:观察分析脑钠肽前体及肌钙蛋白I在老年急性有机磷中毒心肌损伤中的变化情况.方法:选取天津市第一中心医院138例急性有机磷中毒患者根据中毒情况分为轻度组、中度组和重度组,另随机选取32例患者作为对照组.统计各组患者血清中CK、CK-MB、cTnI、NT-proBN、ALT和LDH浓度情况,分析急性有机磷中毒患者住院期间心脏病变、死亡率、IMS、MODS和猝死发生情况.结果:轻度组患者的NT-proBN、ALT和LDH均明显高于对照组患者,中度组和重度组患者的CK、CK-MB、cTn I、NT-proBN、ALT和LDH均明显高于轻度组和对照组患者,重度组患者的CK、CK-MB、cTn I、NT-proB N、ALT和LDH均明显高于中度组患者,差异均具有统计学意义(P<0.05);中度组和重度组患者心脏相关症状、心电图变化、IMS、MODS、猝死和住院期间死亡的发生率明显高于轻度组患者,重度组患者出现心脏相关症状、心电图变化和IMS的比例明显高于中度组患者,差异均具有统计学意义(P<0.05),而中度组和重度组患者发生MODS、猝死比例和住院期间死亡率比较差异无统计学意义(P>0.05).结论:急性有机磷中毒可导致老年患者心肌严重损伤,对患者心肌酶谱和脑纳肽前体物质的监测可预测病情,具有重要临床意义.

AIM： To observe and analyze the value of brain natriuretic peptide and troponin Ⅰ of elderly patients with acute organophosphate poisoning. METHODS： A total of 138 patients with acute organophosphate poisoning were divided into the mild group,the moderate group and the severe group according to poisoning situation. Another 32 patients without cardiac dysfunction were randomly selected as the control group. Serum CK,CK-MB,cT n I,NT-proB NP,ALT and LDH concentrations of all groups were observed,and the occurrence of heart disease,mortality,IMS,MODS and sudden death of patients with acute organophosphorus poisoning during hospitalization were analyzed. RESULTS：NT-proB NP,ALT and LDH of the mild group patients were higher than those of the control group patients,with a statiscally significant difference（ P〈0.05）. CK,CK-MB,cTn I,NT-proB NP,ALT and LDH of the moderate group and the severe group were higher than those of he mild group patients and the control group patients,and the difference was statiscally significant（ P〈0.05）. CK,CK-MB,cTn I,NT-proB NP,ALT and LDH of the severe group patients were significantly higher than those of the moderate group,with a statiscally significant difference（ P〈0.05）. The incidence of the heart-related symptoms,ECG changes,death during hospitalization,IMS,MODS and sudden death of the moderate group and the severe group patients were significant higher than those of the mild group patients（ P〈0.05）. The incidence of the heart-related symptoms,ECG changes and IMS were significant higher than those of the moderate group patients（ P〈0.05）. The incidence of MODS,the proportion of sudden death during hospitalization and mortality of the moderate group and the severe group had no significant difference（P〈0.05）.CONCLUSION： Acute organophosphate poisoning can cause severe cardiomyopathy damage in elderly patients. The monitoring of brain natriuretic peptide and troponin I of patients can predict the disease condition and has important clinical significance.