摘要
目的探讨脑钠肽前体(NT-proBNP)与肌钙蛋白(cTnⅠ)在老年人急性有机磷农药中毒(AOPP)心肌损伤中的变化及临床价值。方法随机选取老年AOPP120例,据中毒情况分三组:轻度组30例,中度组42例,重度组48例。选取同期的50例健康体检者为对照组。分别于患者入院后4小时、3天、7天分别抽取静脉血,测定其NT-proBNP、cTnⅠ、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)值,同时与对照组进行比较;120例患者中合并出现中间型综合征有46例(IMS组),非IMS组74例,分别对比IMS组、非IMS组与对照组的各项指标及心电监测情况。结果中、重度组患者NT-proBNP、cTnⅠ、CK、CK-MB测定值明显高于对照组(P<0.05),轻度组患者NT-proBNP测定值明显高于对照组(P<0.05),其余三项测定指标与对照组比较无统计学意义(P>0.05);轻中重三组NT-proBNP、cTnⅠ、CK、CK-MB值在同一时间组间两两比较测定值差异均有统计学意义(P<0.05),非IMS组的心电图ST-T、房室传导阻滞(AVB)、室性心动过速(VT)变化比例比IMS组低(P<0.05);重度组患者MODS及猝死发生率高于中度组(P<0.05)。结论随着老年AOPP患者中毒情况加重,其NT-proBNP及cTnⅠ的升高越明显,对患者的NT-proBNP进行检测可以很好地反映其心肌损伤程度。
Objective To explore the changes and the clinical significance of N-terminal pro-brain natriuretic peptide（ NTproBNP） and cardiac troponin I（ cTnⅠ） in myocardium damage of elderly patients with acute organophosphate pesticide poisoning（ AOPP）. Methods 120 elderly patients with acute organophosphate pesticide poisoning were randomly and equally selected as example and were devided into three groups according to the degree of poisoning： mild poisoning group of 30 cases（ mild）,moderate poisoning group of 42 cases（ moderate） and severe poisoning group of 38 cases（ severe）. 50 healthy physical examinees at the same period were taken as the control group. All patients were extracted venous blood at 4 h,3 d and 7 d after admission to determine N-terminalpro-brain natriuretic peptide（ NT-proBNP）,Cardiac Troponin I（ cTnⅠ）,creatine kinase（ CK） and creatine kinase isoenzyme（ CK-MB）. The result was compared with the control group in the same period; Among the 120 cases,there were 46 cases with intermediate myasthenia syndrome（ IMS group） and 74 cases without IMS（ non-IMS group）. All indexes and the status of ECG monitoring of the IMS group,the non-IMS group and the control group were compared. Results The CK,CK-MB,cTnⅠ and NT-proBNP of moderate and severe poisoning groups were significantly higher than those in control group（ P 0. 05）,while the NT-proBNP of mild poisoning groups were significantly higher than those in control group（ P 0. 05）,and the other three testing indexes had no statistical significance compared with the control group（ P 0. 05）; Statistical significance in the paired comparison was found in NT-proBNP,cTnⅠ,CK and CK-MB of mild,moderate and severe poisoning groups（ P 0. 05）. The change of rate of Electrocardiogram ST-T,atrioventricular block（ AVB） and ventricular tachycardia（ VT） in non-IMS group were lower than those in IMS group（ P 0. 05）; the incidence of MODS and sudden death in severe poisoning group were higher than those in moderate group（ P 0. 05）. Conclusions With the increase of the degree of the elderly patients＇ AOPP,the NT-proBNP and cTnⅠ increase more significantly. The test of patients＇ NTproBNP can reflect the degree of myocardial damage in more detail.
出处
《心脑血管病防治》
2017年第6期435-438,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
关键词
中毒
有机磷化合物
脑钠肽前体
肌钙蛋白
Poisoning
Organophosphorus compounds
N-Terminal pro-brain natriuretic peptide
Cardiac Troponin
作者简介
赵琳琳（1980-）副主任医师
