急性砷化氢中毒对心电图及心肌酶影响的研究

Effect of acute arsine poisoning on electrocardiogram and myocardial enzyme

目的探讨急性砷化氢中毒对心电图及心肌酶影响,以便早期进行临床诊治,降低死亡率。方法回顾性分析2009年12月至2014年12月62例急性砷化氢中毒患者,按《职业性急性砷化氢中毒诊断标准》分成轻度、中度、重度组,用心电图仪和全自动生化仪检测患者心电图和心肌酶。结果心电图异常48例,发生率为77.42%,其中ST-T改变发生率95.83%,窦性心动过速发生率77.08%,室性早搏发生率60.42%,以上3种异常心电图和其他异常指标相比差异显著(P<0.05);心肌酶含量与急性砷化氢中毒程度呈正相关;心电图异常组天冬氨酸氨基转移酶(AST)、肌酸磷酸肌酶(CK)、乳酸脱氢酶(LD)、α-羟丁酸脱氢酶(α-HBD)明显高于心电图正常组(P<0.05)。结论心电图和心肌酶可作为急性砷化氢中毒心脏损害的有效指标。

Objective To investigate the effect of acute arsine poisoning on electrocardiogram（ ECG） and cardiac enzymes for early clinical diagnosis and treatment,and to reduce the mortality. Methods A retrospective analysis on 62 acute arsine poisoning patients selected from December 2009 to December 2014 was conducted,who were divided into mild,moderate and severe group according to Diagnostic Criteria of Occupational Acute Arsine Poisoning. ECG and cardiac enzymes were detected with ECG and automatic biochemical analyzer. Results Forty- eight cases of abnormal electrocardiogram were found with incidence rate of 77. 42%,ST- T changes occurrence rate was 95. 83%,sinus tachycardia incidence rate was 77. 08%,incidence rate of ventricular premature beat was 60. 42%,the above three kinds of abnormal ECG were significantly other different from other anomaly index（ P 〈 0. 05）; enzymes severity and extent of acute arsine poisoning were positively correlated; AST,CK,LD,the α- HBD index of ECG abnormalities group were significantly higher than normal ECG group（ P 〈 0. 05）. Conclusion ECG and cardiac enzymes can be valid indicator of heart damage of acute arsine poisoning.