老年百草枯中毒患者血清酶学水平的动态变化

Dynamic change of serum enzymology level of elderly paraquat poisoning patients

目的探讨老年百草枯中毒患者血清酶学水平的动态变化。方法选取56例老年百草枯中毒患者作为研究组,同期体检的健康人群70例作为健康对照组。检测老年百草枯中毒患者血清肌酸激酶(CK)、CK同工酶(CK-MB)、乳酸脱氢酶(LDH)、碱性磷酸酶(AST)等指标。结果与健康对照组比较,中毒第1天轻度组血清CK、CK-MB、LDH、AST水平差异无统计学意义(P>0.05);但中度组和重度组患者血清CK、CK-MB、LDH、AST水平均高于健康对照组(P<0.05);且三组间两两比较均有统计学差异(P<0.05)。轻度组血清CK、CK-MB、LDH、AST水平在第3天达峰值,但在第7天开始下降。中度组和重度组血清CK、CK-MB、LDH、AST水平不断升高,在第7天达到峰值。第3、7天时,三组间血清CK、CK-MB、LDH、AST水平两两比较均有统计学差异(P<0.05)。结论百草枯中毒可造成老年患者心肌损害持续性加重,且心肌损害程度与百草枯中毒程度相关。

Objective To study dynamic change of serum enzymology level of elderly paraquat poisoning patients. Methods 56 senile patients with paraquat poisoning were selected as the teams, and 70 cases of healthy people for physical examination were selected as the healthy controls. The levels of serum creatine kinase （ CK）, CK isoenzyme （ CK-MB ）, lactate dehydrogenase （ LDH ）, alkaline phosphatase （AST） were detected. Results At the first day, the serum CK, CK-MB, LDH, AST levels of patients in moderate and severe groups were higher than those of healthy controls （P〈0.05）. On the third day, serum levels of CK, CK-MB, LDH and AST of mild group reached the peak, but at the 7th d serum CK, CK-MB,LDH,AST levels began to decline. In moderate and severe groups, serum CK, CK-MB, LDH, AST levels were rised, and 7 d after poisoning they peaked. At 3th,7th day after poisoning, the serum CK, CK-MB, LDH, AST levels between the 3 groups had statistical significances （ P〈0. 05 ）. Conclusions Paraquat poisoning could cause the sustainability of aggravating myocardial damage of elderly patients, and myocardial damage levels related to the degree of paraquat poisoning. Clinically paraquat poisoning degree and the condition can be evaluated by monitoring the dynamic changes of myocardial enzymology of paraquat poisoning patients.