急性乌头碱中毒患者临床表现、ECG特点和血生化指标检测结果的分析

Analysis of clinical manifestations,ECG characteristics and blood bioche mical indexes in patients with acute aconitine poisoning

目的:研究急性乌头碱中毒患者的临床表现、心电图(Electrocardiogram,ECG)特点和血生化指标检测结果。方法:本研究以2018年1月至2021年12月在遵义医科大学附属医院就诊的40例乌头碱中毒患者作为研究对象。将其分为轻度组、重度组。比较轻度组、重度组患者临床表现、ECG特点和血生化指标之间的差异。结果:轻度、重度乌头碱中毒患者唇舌发麻、肢体发麻、胸闷、心悸、恶心呕吐、意识障碍、黑朦、昏迷、休克、心律不齐、肾衰竭、意识模糊发生情况之间的差异存在统计学意义(P<0.05)。轻度、重度乌头碱中毒患者窦性心动过缓、窦性心动过速、ST段压低及T波倒置、QT间期延长、一度房室传导阻滞、房性期前收缩、室性期前收缩、频发多源室性期前收缩、室性心动过速、心室颤动发生情况之间的差异存在统计学意义(P<0.05)。轻度、重度乌头碱中毒患者天冬氨酸转氨酶、碱性磷酸酶、间接胆红素、血尿素氮、血肌酐、血尿酸、血钾离子、血钠离子、血氯离子、血磷、肌酸激酶同工酶、血心肌肌钙蛋白T、血降钙素原水平之间的差异存在统计学意义(P<0.05)。结论:急性乌头碱中毒患者的主要表现为临床心电图的改变,建议根据患者的心电图改变早期开展干预,以减轻其心肌细胞的损伤,提升其生命质量。

Objective:To study the clinical manifestations,Electrocardiogram(ECG)characteristics and blood biochemical indexes of patients with acute aconitine poisoning.Methods:In this study,40 cases of aconitine poisoning patients treated in Affiliated Hospital of Zunyi Medical University from January 2018 to December 2021 were selected as research objects.They were divided into mild group and severe group.The differences of clinical manifestations,ECG characteristics and blood biochemical indexes between mild and severe groups were compared.Results:There were statistically significant differences between lip and tongue numbness,limb numbness,chest tightness,palpitation,nausea and vomiting,disturbance of consciousness,amaurosis,coma,shock,arrhythmia,renal failure and fuzzy consciousness in mild and severe aconitine poisoning patients(P<0.05).There were statistically significant differences in the incidence of sinus bradycardia,sinus tachycardia,ST-segment depression and T-wave inversion,QT interval prolongation,first degree atrioventricular block,atrial presystole,ventricular presystole,frequent multiple ventricular presystole,ventricular tachycardia and ventricular fibrillation in patients with mild and severe aconitine poisoning(P<0.05).The levels of aspartate aminotransferase,alkaline phosphatase,indirect bilirubin,blood urea nitrogen,blood creatinine,blood uric acid,blood potassium ion,blood sodium ion,blood chloride ion,blood phosphorus,creatine kinase isoenzyme,blood cardiac troponin T and blood procalcitonin in patients with mild and severe aconitine poisoning were statistically significant(P<0.05).Conclusion:The main manifestation of patients with acute aconitine poisoning is the change of clinical electrocardiogram.It is suggested to carry out early intervention according to the change of electrocardiogram in patients,so as to reduce the damage of my ocardial cells and improve the quality of life.