【摘要】 目的探讨一氧化碳中毒患者心功能指标与迟发脑病的相关性。方法选择2012年5月~2015年6月在河北省唐县人民医院(以下简称"我院")住院的一氧化碳中毒合并迟发脑病患者60例作为A组,选择同期在我院住院的一氧化碳中毒未合并迟发脑病患者60例作为B组,C组为我院同期健康体检者。三组均进行心电图检查、心功能指标检测、心肌酶谱和同工酶的测定,同时进行相关性分析。结果 A组与B组的室颤、房室传导阻滞、QTc延长、ST低平、房(室)早、窦缓(速)等心电图异常发生情况明显高于C组(P<0.05);A组与B组的左室射血分数(LVEF)明显低于C组,而左室收缩末期容积指数(LVESVI)、左室舒张末期容积指数(LVEDVI)明显高于C组,差异均有统计学意义(P<0.05),A组与B组之间比较差异无统计学意义(P>0.05)。A组与B组的血浆乳酸脱氢酶(LDH)、肌酸激酶(CK)、天门冬氨酸氨基转移酶(AST)、肌酸激酶同工酶(CK-MB)、肌钙蛋白(c Tn I)均明显高于C组(P<0.05),同时A组的血浆CK、CK-MB与c Tn I也均明显高于B组(P<0.05)。多变量Logistic回归分析结果表明,CK、CK-MB和c Tn I为导致一氧化碳中毒合并迟发脑病发生的独立危险因素(P<0.05)。结论一氧化碳中毒多伴有心电图、超声心动图、心肌酶谱和同工酶的异常表现或表达,其中血CK、CK-MB和c Tn I含量为迟发脑病发生的独立危险因素,动态观察血CK、CK-MB和c Tn I的变化有助于对迟发脑病作出判断并指导治疗。更多还原

【Abstract】 Objective To investigate the correlation of the indexes of cardiac function and delayed encephalopathy in patients with carbon monoxide poisoning.Methods Sixty patients with carbon monoxide poisoning combined with delayed encephalopathy hospitalized in Tangxian People’s Hospital("our hospital" for short) from May 2012 to June 2015 were selected as group A,60 patients with carbon monoxide poisoning without delayed encephalopathy hospitalized in our hospital at the same time were selected as group B,60 healthy examined persons in our hospital at the same time were selected as group C.All the three groups were carried out ECG examination,cardiac function,myocardial enzymes and isozyme detection,while they were given the correlation analysis.Results The ventricular fibrillation,atrioventricular block,QTc prolonged,ST flat,room(chamber) morning,sinus bradycardia(speed),and other ECG abnormalities in the group A and group B were significantly higher than those of group C(P<0.05); and the left ventricular ejection fraction(LVEF) of group A and group B were significantly lower than that of group C,while the left ventricular endsystolic volume index(LVESVI) and left ventricular end-diastolic volume(LVEDVI) were significantly higher than those of group C,the differences were all statistically significant(P<0.05),while there were no statistically significant differences between group A and group B(P>0.05).The plasma lactic dehydrogenase(LDH),creatine kinase(CK),aspartate aminotransferase(AST),creatine kinase isoenzyme(CK-MB),troponin(cTnI) in the group A and group B were all significantly higher than those of group C(P<0.05),at the same time,the plasma CK,CK-MB and cTnI in the group A were significantly higher than those of group B(P<0.05).Multivariate logistic regression analysis showed that,CK,CK-MB and cTnI were the independent risks for the carbon monoxide poisoning combined with delayed encephalopathy(P<0.05).Conclusion The carbon monoxide poisoning is offen combined with aberrant patterns or expression of ECG,echocardiography,myocardial enzyme and isozyme,among which,the plasma CK,CK-MB and cTnI were the independent risk factors of delayed encephalopathy,dynamic observation of plasma CK,CK-MB and cTnI changes is helpful to judge the delayed encephalopathy and to guide treatment.更多还原