【作者】 刘海峰； 李玲文； 田力； 卢中秋；

【Author】 Liu Hai-Feng~1 Li Ling-Wen~2 Tian Li~3 Lu Zhong-Qiu~1 (1 Department of Emergency, 2 Department of Electrocardiogram,The First Affiliated Hospital of Wen Zhou Medical College,Wenzhou 325000,China; 3 Ward of Cadre,Shenfing Hospital,China Medical University,Shenyang 110004,China)

【机构】 温州医学院附属第一医院急诊科； 温州医学院附属第一医院心电图室； 中国医科大学盛京医院干诊科；

【摘要】 目的通过观察糖尿病酮症酸中毒患者的心肌酶谱以及心电图改变,了解糖尿病酮症酸中毒对心肌的损害,进一步明确心肌酶谱以及心电图改变的意义。方法检测并比较19 例糖尿病酮症酸中毒患者急性期以及缓解期的心肌酶谱,包括肌酸磷酸激酶(CPK)、肌酸磷酸激酶同功酶(CPK-MB)、天门冬氨基转移酶(AST)及肌钙蛋白-1(cTn-1);同时观察并比较患者的心电图变化。结果 19例患者急性期的 CPK、CPK-MB 以及 AST 与缓解期比较明显升高, 有统计学意义(P<0.05);急性期患者的 CPK-MB 与 CPI(无相关性(r=0.13)。19例急性期患者心电图异常者12(63.2%)例,主要异常是窦性心动过速10(52.6%)例以及 ST-T 改变8 (42.1%)例。急性期心电图异常组患者的 CPK、CPK-MB 以及 AST 明显高于心电图正常组 (P<0.05)。结论糖尿病酮症酸中毒患者心肌酶谱可以出现异常升高,糖尿病酮症酸中毒伴有心肌细胞的一过性非特异性损伤;糖尿病酮症酸中毒越重,患者越容易发生心律失常。更多还原

【Abstract】 Aim To observe the myocardium damage caused by diabetic ketoacidosis with myocardial enzymogram and electrocardiogram and confirm their clinical significances. Methods 19 hospitalized patients had their vein blood drawn for determinating myocardial enzymogram which included creatine phosphokinase(CPK),creatinine phosphokinase-MB(CPK-MB),aspartate aminotransferases(AST)and cardiac troponin i(cTn-Ⅰ); Meanwhile,the changes of electrocardiogram were recorded.The changes of myocardial enzymogram and electrocardiogram at acute stage were compared with those at catabatic stage. Results 19 patients with diabetic ketoacidosis had significantly higher levels of myocardial enzymogram at acute stage than those at catabatic stage(P<0.05).CPK-MB and CPK values of 19 patients at acute stage had no correlation(r=0.13).12(63.2%)patients with abnormal electrocardiogram changes at acute stage,and the major abnormities were 10(52.6%)sinus tachycardia,8(42.1%)ST-T change,the levels of myocardial enzymogram with abnormal electrocardiogram changes at acute stage were significantly higher than those with normal electrocardiogram changes(P<0.05).Conclusions The levels of myocardial enzymogram caused by diabetic ketoacidosis might be abnormally higher.There was transient and nonspeciai damage to myocardium.The occurence of arrhythmia varied with the damage of diabetic ketoacidosis to myocardium.更多还原