急性重症毒蕈中毒心肌损害临床研究

Severe Acute Mushroom Poisoning with Myocardial Damage in Clinical Research

目的对急性重症毒蕈中毒心肌损害的治疗方法及预后效果进行探讨。方法整群选取该院2013年5月—2016年5月期间收治的78急性重症毒蕈中毒患者,给予患者解毒、抗心律失常、心肌保护及血液净化等治疗,对治疗前后患者心肌酶谱各项指标变化情况进行对比。结果对于中毒患者,心肌毒性作用非常突出,表现为恶性心律失常、心肌酶谱增高及心电图改变等,同时还具肝肾毒性及胃肠道毒性作用。经过治疗,患者血清肌酐(101.0±7.0)umol/L、尿素氮(6.8±0.7)mmol/L、丙氨酸氨基转移酶(68.0±14.0)U/L、天门冬氨酸氨基转移酶(79.0±27.0)U/L、乳酸脱氢酶(230.0±33.0)U/L、肌酸激酶(183.0±30.0)U/L、肌酸激酶同工酶(40.0±8.0)U/L、肌钙蛋白(1.20±0.02)ng/m L等指标明显低于治疗前,差异有统计学意义,P<0.05。结论急性重症毒蕈中毒患者心肌毒性作用比较明显,容易导致恶性心律失常发生,采取有效的治疗方法,能够提高患者治疗效果,预后较好。

b Objective The treatment method of severe acute mushroom poisoning with myocardial damage and prognosis were discussed. Methods Group selection in our hospital from May 2013 - May 2016 admitted during the period of 78 severe acute mushroom poisoning patients, treated with detoxification, anti arrhythmia, myocardial protection and blood purification treatment, compared before and after treatment in patients with myocardial enzyme changes of the indicators. Results For poisoning patients, myocardial toxicity is very prominent, and the performance of malignant arrhythmia, myocardial enzyme spectrum and ECG changes, etc., but also with liver and kidney toxicity and gastrointestinal toxicity. There were sta-tistically significant differences after treatment, serum creatinine （101.0±7.0） umol/ L, urea nitrogen （6.8±0.7） mmol/ L, alanine amino shift enzyme （68.0±14.0） U/U aspartic acid amino transferase（79.0±27.0）U/ L, lactate dehydrogenase（230.0±33.0） U/ L, creatine kinase （1.83±30.0） U/ L, creatine kinase isoenzyme （40.0±8.0） U/ L, troponin （1.20±0.02） ng/ mL, etc. index were significantly lower than that before treatment,P 〈 0.05. Conclusion Urgent Of severe mushroom poisoning patients with cardiac toxicity is obvious, can easily lead to the occurrence of malignant arrhythmia and take effective treatment, can improve the effect of treatment in patients with good prognosis.