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目的分析急性百草枯中毒患者早期心、肝、肾功能变化,探讨其对预后的影响。方法用酶法分别检测68例急性百草枯中毒患者(中毒时间<24h)入院时心肌酶、血清谷丙转氨酶(ALT)、总胆红素(TBil)、血清尿素氮(Bun)、肌酐(Cr)以及检查胸片;统计患者中毒剂量和中毒时间,并进行APACHEⅡ评分。依据临床结局分为猝死组(生存时间≤24h组)和非猝死组(生存时间>24h组)。结果中毒患者猝死组与非猝死组的中毒时间、中毒剂量比较差异有统计学意义(P<0.05,P<0.01),两组患者年龄、性别比、APACHEⅡ评分比较差异无统计学差异意义(P>0.05);猝死组心肌酶、血清ALT、TBil、Cr均显著升高,与非猝死组比较差异有统计学意义(P<0.01)。结论百草枯中毒猝死患者早期出现严重的中毒性心、肝、肾损害,救治过程中应强调重要器官保护并及早干预;中毒后血清心肌酶活性的显著升高可能是发生猝死的一个预警指标。
Objective To analyze the changes of early heart, liver and kidney function in patients with acute paraquat poisoning and to explore its impact on prognosis. Methods Serum enzyme, serum ALT, TBil, serum creatinine (Cr), creatinine (Cr) and serum creatinine were detected in 68 cases of acute paraquat poisoning (poisoning time <24h) ) And chest X-ray examination; poisoning patients and poisoning time statistics, and APACHE Ⅱ score. According to the clinical outcome, the patients were divided into sudden death group (survival time≤24h group) and non-sudden death group (survival time> 24h group). Results There were significant differences in the poisoning time and poisoning dose between the sudden death group and the non-sudden death group (P <0.05, P <0.01). There was no significant difference in age, sex ratio and APACHEⅡ score between the two groups > 0.05). The levels of myocardial enzymes, serum ALT, TBil and Cr in sudden death group were significantly higher than those in non-sudden death group (P <0.01). Conclusion Severe poisoned heart, liver and kidney damage occurred in patients with sudden death from paraquat poisoning. Important organ protection and early intervention should be emphasized during treatment. A significant increase of serum myocardial enzyme activity after poisoning may be an early warning indicator of sudden death.