【摘要】 目的观察急性中、重度硫化氢中毒患者给予高压氧治疗的时机对患者血清心肌肌钙蛋白Ⅰ(CTnⅠ)的影响及其预后的关系。方法根据患者发病到首次进入高压氧的时间将患者归为三组。A组23例均在发病2h内开始接受高压氧治疗,B组15例为发病后2~6h接受高压氧治疗,C组8例发病到首次进入高压氧治疗为6h以上。回顾性观察三组患者入院即刻、第2天、第5天及第10天血清CTnⅠ的定量测定值进行比较,对比三组患者血清TNⅠ的变化规律及预后。结果三组患者治疗前的CTnⅠ测定值差异无统计学意义(P>0.05);第2天血清CTnⅠ均达到高峰,但峰值差异有统计学意义(A组与B组比较P<0.05;C组与A组比P<0.01),第5天及第10天各组CTnⅠ差异仍有统计学意义。A组患者治愈17例,好转4例,总有效率21/23;B组患者治愈9例,好转3例,有效率12/15;C组患者治愈1例,好转3例,有效率4/8,各组有效率差异有统计学意义(P<0.01)。结论中、重度硫化氢中毒患者进入高压氧治疗越早,血清CTnⅠ值恢复越快,心肌损害越轻,预后越好。更多还原

【Abstract】 Objective To investigate the relationship between the optimum time of hyperbaric oxygen treatment and the change of serum cardiac troponin Ⅰ (CTnⅠ) and prognosis in acutely moderate or severe hydrogen sulfide intoxication cases. Methods 46 patients were divided into three groups according to the intervals between the outbreak of acute hydrogen sulfide intoxication and the first treatment of hyperbaric oxygen: Group A (<2 h intervals, n=23).Group B (2~6 h intervals, n=15).Group C (>6 h intervals, n=8).The quantitative determination values of serum CTnⅠ were recorded in every group after hospitalization immediately, on the 2nd day, the 5th day and the 10th day. Retrospective studies were conducted to find out the regularity of serum CTnⅠ and prognosis. Results There were no differences in CTnI among three groups before treatment(P>0.05). The concentration of CTnⅠ in serum peaked at the 2nd day, but there were differences in the peaks between Group A and Group B (P<0.05), and between Group C and Group A (P<0.01).There were still significant differences among three groups in CTnI at the 5th day and 10th day. In Group A, 17 cases were cured, 4 cases improved, and total effective rate was 21/23. In Group B, 9 were cured, 3 improved, and total effective rate was 12/15; In Group C, 1 was cured, 3 improved, and total effective rate was 4/8. There was statistical significance in the total effective rate among three groups (P<0.01). Conclusion Early hyperbaric oxygen treatment in the moderate or severe hydrogen sulfide intoxication cases is beneficial to fast recovery of serum CTnⅠ, lessening the myocardial lesion, the better prognosis.更多还原