急性敌敌畏中毒合并急性乙醇中毒患者心肌损害临床观察

目的探讨急性敌敌畏中毒合并急性乙醇中毒患者心肌酶学及心电图变化,了解混合中毒时心肌损害情况。方法将108例急性重度敌敌畏中毒患者分为单纯敌敌畏中毒组(48例)、敌敌畏中毒合并乙醇中毒组(60例),入院后24h内抽取空腹静脉血测定肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(HBDH)、天冬氨酸氨基转移酶(AST),并常规描记体表心电图。结果急性敌敌畏中毒合并急性乙醇中毒患者心肌酶明显高于单纯敌敌畏中毒组(P0.01);混合中毒组室性早搏、室性心动过速发生率高于单纯中毒组。结论与单纯敌敌畏中毒相比,急性敌敌畏中毒合并急性乙醇中毒患者心肌损害重,更易导致恶性心律失常的发生。

Clinical observation on myocardial damage of patients with acute dichlorvos poisoning complicated with acute alcoholism

[Objective]To investigate the changes of myocardial enzyme and electrocardiogram of patients with acute dichlorvos poisoning complicated with acute alcoholism,know the myocardial damage of mixed poisoning.[Methods]108 cases of severe acute dichlorvos poisoning were divided into the dichlorvos poisoning group（48 cases） and dichlorvos poisoning complicated with alcoholism group（60 cases）.The fasting venous blood samples were taken within 24h after admission,to determine the creatine kinase（CK）,creatine kinase isoenzyme（CK-MB）,lactate dehydrogenase（LDH）,α-hydroxybutyrate dehydrogenase（HBDH） and aspartate aminotransferase（AST）,and the surface electrocardiogram was recorded.[Results]The myocardial enzyme level of dichlorvos poisoning complicated with alcoholism group was significantly higher than that of the dichlorvos poisoning group（P0.01）.The incidence rates of ventricular premature beat and ventricular tachycardia of the mixed poisoning group were higher than those of single dichlorvos poisoning group.[Conclusion]Compared with the single dichlorvos poisoning group,the myocardial damage of patients with acute dichlorvos poisoning complicated with acute alcoholism is more serious,and the incidence rate of malignant arrhythmia is higher.