摘要
目的研究超敏肌钙蛋白I(high-sensitivity cardiac troponin I,hs-cTnI)和可溶性致癌抑制因子2(soluble suppression of tumorigenicity 2,sST2)对急性有机磷农药中毒(acute organophosphoruspesticide poisoning,AOPP)患者心肌损伤程度的早期诊断价值。方法选择2014年3月至2018年10月衡水市人民医院住院治疗的AOPP患者168例,按照AOPP中毒诊断分级,分为轻度组45例、中度组55例及重度组68例。另选30例同期健康体检者为对照组。分别于入院后1、4、12 h检测肌钙蛋白(cTnI)、hs-cTnI、N末端B型钠尿肽(NT-proBNP)和sST2水平。应用SPSS 21.0进行统计分析。计量资料采用均数±标准差(Mean±SD)表示,组间两两比较采用LSD-t检验,多组间比较采用单因素方差分析。相关性分析用Spearman相关检验。结果入院后1 h,不同中毒程度AOPP患者hs-cTnI均高于对照组,重度组高于轻中度组;组间比较差异有统计学意义(P<0.05);但cTnI水平差异无统计学意义(P>0.05)。入院后4 h、12 h,随着中毒程度增加以及时间延长,cTnI、hs-cTnI水平均呈递增趋势,并且入院后12 h水平显著高于入院后4 h,组间比较差异有统计学意义(P<0.05)。入院后1 h,中毒患者sST2水平高于对照组,重度组高于轻中度组;入院后4 h、12 h ,sST2水平明显升高,以重度组最为显著;入院后12 h,sST2水平显著高于入院后4 h,组间比较差异有统计学意义(P<0.05)。入院后1 h NT-proBNP浓度在正常范围。入院后4 h、12 h,NT-proBNP随时间逐渐升高,重度组明显高于各组,组间比较差异有统计学意义(P<0.05)。相关性分析显示,AOPP患者hs-TnI和sST2呈正相关(r=0.776, P<0.01)。hs-TnI浓度和sST2浓度与AOPP病情程度均呈正相关(r=0.958, P<0.01;r=0.844, P<0.01)。即患者中毒程度越重,hs-TnI和sST2浓度越高,心肌损伤越重。结论尽早检测AOPP患者hs-cTnI、sST2水平,可早期识别心肌损害,客观评价心肌损害的程度。
Objective To study the early diagnostic value of high-sensitivity cardiac troponin I(hs-cTnI) and soluble growth stimulating gene 2 protein (soluble suppression of tumorigenicity 2, sST2) in myocardial injury of acute organophosphorus pesticide poisoning (AOPP). Methods Totally 168 AOPP patients hospitalized from March 2014 to October 2018 were divided into the mild group (n=45), moderate group (n=55) and severe group (n=68). Another 30 healthy persons were served as the control group. The levels of cTnI, hs-cTnI, N-terminal B-type natriuretic peptide(NT-proBNP) and sST2 were detected at 4 h and 12 h after admission. SPSS 21.0 was used for statistical analysis. The measurement data were expressed by mean±standard deviation, two groups were compared by LSD-t test, and the multigroup comparison was made by single factor analysis of variance (ANOVA). The correlation analysis by Spearman correlation test (P<0.05). Results At 1 h after admission, the hs-cTnI of AOPP patients with different degrees of poisoning was higher than that of control group, and that of severe group was higher than that of mild to moderate group. Comparison between groups was statistically significant (P<0.05). However, there was no significant difference in the cTnI level (P>0.05). At 4 h and 12 h after admission, the levels of cTnI and hs-cTnI increased with the increase of poisoning degree and the extension of time, and their level at 12 h after admission were significantly higher than those at 4 h after admission, with statistically significant difference between the two groups (P<0.05). At 1 h after admission, the level of sST2 in the poisoned patients was higher than that in the control group, and the level in the severe group was higher than that in the mild to moderate groups. At 4 h and 12 h after admission, the level of sST2 was increased significantly, especially in the severe group. The level of sST2 at 12 h after admission was significantly higher than that at 4 h after admission (P<0.05). The concentration of NT-proBNP was in nor
作者
刘晓婷
王磊
陈静
齐洪娜
马国营
Liu Xiaoting;Wang Lei;Chen Jing;Qi Hongna;Ma Guoying(EICU, Hengshui People's Hospital, Hengshui 053000, China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2019年第3期298-302,共5页
Chinese Journal of Emergency Medicine
基金
2017年衡水市科研基金( 2017014049Z).
关键词
急性有机磷农药中毒
超敏肌钙蛋白I
可溶性致癌抑制因子2蛋白
N末端B型钠尿肽
Acute organophosphoruspesticide poisoning
High-sensitivity cardiac troponin I
Soluble suppression of tumorigenicity 2
N-terminal B-type natriuretic peptide
