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目的探讨急性砷化氢中毒对心电图及心肌酶影响,以便早期进行临床诊治,降低死亡率。方法回顾性分析2009年12月至2014年12月62例急性砷化氢中毒患者,按《职业性急性砷化氢中毒诊断标准》分成轻度、中度、重度组,用心电图仪和全自动生化仪检测患者心电图和心肌酶。结果心电图异常48例,发生率为77.42%,其中ST-T改变发生率95.83%,窦性心动过速发生率77.08%,室性早搏发生率60.42%,以上3种异常心电图和其他异常指标相比差异显著(P<0.05);心肌酶含量与急性砷化氢中毒程度呈正相关;心电图异常组天冬氨酸氨基转移酶(AST)、肌酸磷酸肌酶(CK)、乳酸脱氢酶(LD)、α-羟丁酸脱氢酶(α-HBD)明显高于心电图正常组(P<0.05)。结论心电图和心肌酶可作为急性砷化氢中毒心脏损害的有效指标。
Objective To investigate the effects of acute arsine poisoning on electrocardiogram (ECG) and myocardial enzymes in order to early clinical diagnosis and treatment and reduce mortality. Methods A retrospective analysis of 62 patients with acute arsine poisoning from December 2009 to December 2014 was divided into mild, moderate and severe groups according to the diagnostic criteria of occupational acute arsine poisoning, with electrocardiograph and fully automatic Biochemical analyzer to detect ECG and myocardial enzymes. Results 48 cases of abnormal electrocardiogram, the incidence was 77.42%, of which ST-T change was 95.83%, the incidence of sinus tachycardia 77.08%, premature ventricular contractions 60.42%, the above three kinds of abnormal ECG and other abnormal indicators (P <0.05). The levels of myocardial enzymes were positively correlated with acute arsine poisoning. The levels of AST, CK, LD ), A-hydroxybutyrate dehydrogenase (α-HBD) was significantly higher than the normal ECG group (P <0.05). Conclusion Electrocardiogram and myocardial enzymes can be used as an effective indicator of heart damage caused by acute arsine poisoning.