急性一氧化碳中毒致心肌损害的临床研究

目的探讨急性一氧化碳(CO)中毒对心脏的损害。方法选取广东省思平市人民医院2000年12月—2005年12月急诊入院的急性CO中毒患者82例,分为轻度、中度和重度中毒3组。同时,在健康体检中随机选取82例健康人为对照组。所有病例入院24h采静脉血。对照组清晨抽空腹静脉血,测定心肌酶并完成12导联心电图描记。结果急性CO中毒患者中有49例血清心肌酶谱改变,占59.8%。中、重度中毒者多有不同程度的心肌酶升高,与健康对照组相比,差异有统计学意义(P<0.01)。重、中度中毒相比,差异亦有统计学意义(P<0.01)。心电图异常改变有57例,占69.5%。经治疗,除2例病重无法康复外,余80例均康复出院,在CO中毒纠正后心肌酶和心电图均恢复正常。结论CO中毒时,对心脏的损害是存在的,在积极治疗中枢神经系统损害的同时,还应积极主动防治和保护CO中毒所致的心脏损害。

Clinical Study of Cardiac Muscle Damage Caused by CO Poisoning

[Objective]To explore the cardiac damage caused by CO poisoning. [Methods]82 cases of acute CO poisoning hospitalized since December of 2000 to December of 2005 in Enping People's Hospital were divided into three groups according to the level of poisoning, namely, the light group, the medium group and the severe group; 82 healthy people were also randomly selected as the control group; vein blood of all the cases was sampled 24 hours after hospitalization; limosis vein blood was sampled in the control group; cardiac muscle enzyme was determined and cardiogram was taken.[ Results]59.8% of the acute CO poisoned patients were found with serum cardiac muscle enzyme changes; the cardiac muscle enzyme in the medium and severe groups increased, the difference was significant compared with the control group (P<0.01); the difference was also significant between the severe group and the medium group (P<0.01); 57 cases (69.5%) were found with abnormal cardiogram. [Conclusion] CO poisoning does cause cardiac damage; preventive measures should be taken to protect the heart while treating neurological damages.