摘要
目的探讨不同心功能分级的急性有机磷农药中毒(AOPP)患者血浆B型脑钠肽原(BNP)水平及超声心动图改变,进一步阐明二者联合检查对AOPP患者左心功能的评价效能。方法回顾分析72例AOPP患者(轻度36例、中度20例、重度16例)的临床资料,其中心功能不全25例、心功能正常47例。应用M型超声心动图测量患者的左室舒张末内径(LVIDd)及左室射血分数(LVEF)值,将心功能分级(Killip分级法)结果与LVEF、BNP水平进行相关性分析;进一步分析超声心动图、血浆BNP检测以及两者联合应用对诊断AOPP并发心功能不全的特异度和灵敏度差异。结果心功能不全组患者LVIDd值和BNP水平明显高于心功能正常组(t=11.375,P=0.030;t=9.015,P=0.037),LVEF值明显低于心功能正常组(t=9.793,P=0.028)。心功能分级与BNP水平呈正相关关系(r=0.91,P<0.05),与LVEF值呈负相关关系(r=-0.792,P<0.05)。超声心动图检查、BNP检测及超声心动图联合BNP检测对于诊断AOPP并发心功能不全的特异度和灵敏度的差异有统计学意义(P<0.05)。结论超声心动图检查联合血浆BNP水平检测可明显提高AOPP患者并发心功能不全的诊断率,对临床治疗有重要的价值。
Objective To investigate the level of plasma B-type pro-brain natriuretic peptide(BNP)level and changes of echocardiogram in patients with acute organophosphorus pesticide poisoning(AOPP)with different levels of cardiac function,to further clarify the value of the combined examination of the two in the evaluation of left ventricular function in patients with AOPP.Methods The clinical data of 72 patients with AOPP(36 mild cases,20 moderate cases,and 16 severe cases)were analyzed retrospectively,and there were 25 cases of central insufficiency and 47 cases of normal cardiac function among them.M-mode echocardiography was used to measure the left ventricular end diastolic diameter(LVIDd)and left ventricular ejection fraction(LVEF)then,the correlation among cardiac function classification(Killip classification),LVEF value and BNP level were analyzed,thereby,further clarify the specificity and sensitivity of echocardiography,plasma BNP level and their combined application in the diagnosis of AOPP complicated with cardiac insufficiency.Results The results showed that the levels of LVIDd and plasma BNP in patients with cardiac insufficiency were significantly higher than that of the normal cardiac function group(t=11.375,P=0.030;t=9.015,P=0.037),while the LVEF value was significantly lower than that of the normal cardiac function group(t=9.793,P=0.028);there was a positive correlation between cardiac function classification and plasma BNP level(r=0.91,P<0.05),and a negatively correlation with LVEF value(r=-0.792,P<0.05).The specificity and sensitivity of echocardiography,plasma BNP level,and their combined application in the diagnosis of AOPP with cardiac insufficiency showed statistical significance(P<0.05).Conclusion The results suggested that the examination of echocardiography combined with the detection of plasma BNP levels can significantly improve the specificity and sensitivity of the diagnosis of AOPP with cardiac insufficiency,which is of important value for clinical diagnosis and treatment of the disease.
作者
江锦雄
郭黎红
蔡承哲
罗青
JIANG Jin-xiong;GUO Li-hong;CAI Cheng-zhe;LUO Qing(Guangzhou Municipal Twelfth People's Hospital/Guangzhou Municipal Prevention and Treatment Hospital for Occupational Diseases,Guangzhou 510620,China)
出处
《中国工业医学杂志》
CAS
2021年第6期483-485,491,共4页
Chinese Journal of Industrial Medicine
