五例急性砷化氢中毒的超声显像特征与临床观察

目的 研究急性砷化氢中毒患者的临床表现及肝、肾、心超声显像特征。方法 监测中毒者心肌酶、肝、肾功能及尿砷变化，采用ATI。公司HDI3000增强型及Toshiba38A二维超声观察患者的肝、肾、心声像改变。结果 (1)5例患者尿砷含量(1例因无尿只测血透析液)为1．9～15．6μmol／L，呈不同程度升高；(2)4例患者WBC不同程度升高或(和)贫血，尿常规均有不同程度异常；(3)4例患者血清心肌酶(CK，AST，LHD和HBDH)有2项以上升高；(4)所有患者的总胆红素和间接胆红素血清尿素氮均增高；(5)二维超声检查5例患者肝、肾的声像表现不同程度异常，1例伴有心脏左房(LA)、左室(LV)径线增大，并有少量心包积液。结论 急性砷化氢中毒的临床表现和肝、肾、心二维超声显像与病理改变基本一致。及早使用血液透析可减少脏器的损害。

Clinical manifestation and ultrasonic characteristics of five patients with acute arsenic poisoning

OBJECTIVE: To study the clinical manifestation and ultrasonic characteristics of liver, kidney and heart of five patients with acute arsenic poisoning. METHODS: The activity of serum myocardial enzymes, function of liver and kidney, and urinary As concentrations were measured. HDI 3000 Enhanced, and Toshiba 38A two dimensional ultrasound was used to examine the ultrasonic echogram of heart, liver, kidney of the patients. RESULTS: (1) The arsenic concentrations in the urine (1.9 approximately 15.6 micromol/L) were higher than the normal value (1.17 micromol/L) in these patients (blood dialytic fluid of one patient with anuria was measured); (2) Four of them had increased WBC, or anemia, and abnormal urine routine to various degree; (3) The activities of serum myocardial enzymes (CK, AST, LDH and HBDH) in 4 patients were at least 2 items increased; (4) Serum bilirubin and urea nitrogen in all patients were increased; (5) The ultrasonic echogram of liver and kidney in these 5 patients showed abnormality to various degree, one of them had slight enlargements in left atrium and ventricle as well as a little pericardial fluid. CONCLUSION: The clinical manifestation and ultrasonic characteristics of liver, kidney, and heart were consistent with the pathologic changes in acute arsenic poisoning. Early blood dialysis may reduce visceral damage.