毒蛇咬伤治疗前后心肌酶变化规律的探讨

Discussion of myocardial enzyme change regulation before and after treatment of venomous snake bite

目的：探讨各种毒蛇咬伤患者治疗前后心肌酶的变化规律。方法：选择近2年住院治疗、属于何种蛇伤诊断明确的毒蛇咬伤患者作为研究对象，这些患者在治疗前后各时段均进行5项心肌酶指标检测，按蛇种、时段及病情对检测结果作出统计分析。结果：5种毒蛇咬伤患者、特别是重症患者均有不同程度的心肌酶水平升高，且治疗后1天仍在高水平、甚至有的患者心肌酶水平还在继续上升。随着治疗的进展，这些指标在治疗后2天和4天的血清水平均逐步下降，在治疗后第4天基本上降至正常水平。蝰蛇咬伤患者的心功能损害最严重，其心肌酶水平明显高于其它4种蛇伤，在治疗前和治疗后1天与其它蛇伤比较均有显著性差异（P〈0．05或P〈0．01）。结论：5种毒蛇咬伤均可使患者心肌酶水平发生变化，但以蝰蛇咬伤对心功能影响最大。

Objective ： To probe into the change regulation of the myocardial enzymes before and after treatment for a variety of snake bite patients. Methods ： The study objects were selected in the hospitalized patients that for clear diagnosis belong to what kind of snakes in the past two years. 5 item myocardial enzymes indexes were determined before and after treatment various periods for these patients. The tested results were made to statistical analysis according to kind of snakes, periods and disease condition.Results ： 5 kinds snake bite patients, especially severe cases patients all have rise of the myocardial enzymes levels in different degree and are high level after treatment first day and the myocardial enzymes levels still further raise for some patients. The sera levels of these indexes all gradually reduce after treatment second day and fourth day with the progress of the treatment and basically reduce to normal levels after treatment fourth day. The heart function damages are best severe and the myocardial enzymes levels apparently are high to 4 other kinds snake bite for the viper bite patients. The viper bite in contrast to other snake bite all have significant difference before treatment and after treatment first day（P〈0.05 or P〈0.01）. Conclusions ： 5 kinds snake bite all may lead to the myocardial enzymes levels of patients happening alteration but the viper bite is largest for influence of the heart function.