急性毒鼠强中毒血清心肌酶谱的变化及其临床意义

目的　探讨急性毒鼠强中毒血清心肌酶的变化规律及其临床意义。方法　动态测定 4 2例急性毒鼠强中毒患者和 4 0例正常健康人的血清心肌酶 ,根据其不同的临床表现分为轻、中、重三组 ,所测得的结果分别与健康对照组对照 ,同时做心电图检查。结果　急性毒鼠强中毒患者的血清心肌酶均有不同程度的升高 ,且与中毒程度呈正相关 ,但轻型组的各酶和中型组的CK MB与对照组比较无统计学差异 ,随着骨骼肌抽搐被控制 ,升高的心肌酶逐渐下降 ,重型组心电图异常者占 4 1 7% ,重型组中心电图异常组的CK MB高于心电图正常组。结论　急性毒鼠强中毒可使血清心肌酶升高 ,其升高的程度与中毒的轻重呈正相关 ,动态观测血清心肌酶的变化对判断病情和治疗效果有一定的临床意义。

Changes of serum myocardial enzyme and its clinical significance in patients with acute tetramine poisoning

Objective To investigate changes of serum myocardial enzyme and its clinical significance in patients with acute tetramine poisoning.Methods levels of serum myocardial enzyme were dynamically measured in all cases,including 42 patients and 40 volunteers.The patients were divided into three groups,based on severity of tetramine poisoning,as low-grade group,medium-grade group and serious-grade group,and all three groups' serum myocardial enzymes' results were compared to control group,respectively.The changes in electrocardiogram(ECG) were determined in all patients.Results levels of serum myocardial enzyme show diverse elevations in all patients with acute tetramine poisoning,which were correlated positively with severity of diseases.No significance was observed between low-grade group and control group in serum myocardial enzyme,neither was between medium-grade group and control group in serum creatine phosphokinase isoenzyme(CK-MB).When convulsions of skeletal muscles had been controlled,high levels of serum myocardial enzyme returned to normal levels gradually.It was also found that 41.7 percents of patients in serious-grade group had abnormal ECG,and their serum myocardial enzyme levels significantly increased,compared to the others who had normal ECG in serious-grade group.Conclusion High levels of serum myocardial enzyme in patients with acute tetramine poisoning may be due to convulsions of skeletal muscles and reperfusion injury caused by hypoxia,partly may result in myocardial injury.Levels of serum myocardial enzyme are correlated positively with severity of tetramine poisoning.It will be a useful method for doctors to assess disease's severity and therapy effect it correctly by dynamically measuring serum myocardial enzymes in patients with acute tetramine poisoning.