以心脏损害为主的急性氟乙酰胺中毒

目的 观察10例急性氟乙酰胺中毒者的心脏损害。方法 监测中毒者住院期间心肌酶和心电图的变化，同时采用动态心电图仪记录患者24h动态心电图进行分析。结果 （1）治疗前有9例患者尿氟均有不同程度升高，治疗期间10例患者均升高；（2）住院期间全部病例心肌酶有1项或多项异常；（3）入院时4例心电图不正常（含3例窦缓），住院期间5例为不正常心电图（也有2例窦缓），出院时全部为正常心电图；（4）动态心电图检查发现有9例出现心脏电交替，1例游走心律，6例心律紊乱。结论 氟乙酰胺对心脏有明显的损害，而且可以引起心脏电交替。

Acute fluoroacetamide poisoning with main damage to the heart

Objective To observe the heart damage in 10 patients with acute fluoroacetamide poisoning. Methods Monitoring serum activities of myocardial enzymescreatine kinase(CK),aspartate aminotransferase(AST),lactate dehydrogenase(LDH) and hydroxybutyrate dehydrogenase(HBDH)]and recording ECG on these 10 patients were performed during the period of their hospitalization.In the mean while,24 hour dynamic ECG were also recorded and analysed using GP7000L Holter. Results (1)Urinary fluorine ion concentrations were increased in 9 patients before therapy and in all these 10 patients during therapeutic period.(2)The activities of serum CK in 2 patients and that of serum HBDH in one patient were increased before therapy.However,the serum activities of one or more than one myocardial enzymes were increased in all these 10 patients during therapeutic period.(3)Four patients had abnormal change of ECG before therapy and 5 patients during therapeutic period.(4)24 hour dynamic ECG records showed that there were heart electrical alternans in 9 patients.One patient had wandering pacemaker and 6 patients had arythmia. Conclusion Fluoroacetamide may cause obvious heart damage,and also heart electrical alternation.