Department of Emergency, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey.
Department of Emergency, Sivas Numune Hospital, Sivas, Turkey.
Rev Med Chil. 2019 Sep;147(9):1128-1135. doi: 10.4067/s0034-98872019000901128.
After acute carbon monoxide intoxication, there may be a higher risk for late adverse cardiac events. However, these patients are usually not followed to monitor the appearance of these effects.
To follow patients seen at an emergency department for carbon monoxide intoxication, monitoring the appearance of myocardial infarction. To assess the predictive value for such complication of serum troponin, carboxyhemoglobin, and procalcitonin levels at the moment of intoxication.
We followed 237 patients receiving emergency care for carbon monoxide intoxication, with a serum carboxyhemoglobin of 5% or more, between 2010 and 2012. Levels of procalcitonin and troponin I were measured. Patients were followed for five years after the intoxication.
During the follow up period, 35 patients had a myocardial infarction. These patients had significantly higher carboxyhemoglobin, procalcitonin and troponin I levels at the moment of the intoxication than their counterparts who did not had a myocardial infarction in the follow up. A logistic regression analysis showed that age, carboxyhemoglobin levels, procalcitonin, troponin 1 and length of CO exposure were associated with a higher risk of myocardial infarction. Procalcitonin, troponin and carboxyhemoglobin levels had a high sensitivity and specificity to predict the appearance of myocardial infarction, with high areas under the receiver operating characteristic (ROC) curves.
In patients with CO intoxication, carboxyhemoglobin, troponin and procalcitonin levels at the moment of the intoxication are significant predictors of the late appearance of myocardial infarction.
急性一氧化碳中毒后，可能会有更高的风险发生晚期不良心脏事件。然而，这些患者通常不会被随访以监测这些影响的出现。
随访在急诊科就诊的一氧化碳中毒患者，监测心肌梗死的发生。评估中毒时血清肌钙蛋白、碳氧血红蛋白和降钙素原水平对这种并发症的预测价值。
我们随访了 2010 年至 2012 年间因碳氧血红蛋白>5%而接受急诊治疗的 237 例一氧化碳中毒患者。测量了降钙素原和肌钙蛋白 I 的水平。患者在中毒后五年内进行随访。
在随访期间，35 例患者发生心肌梗死。与未发生心肌梗死的患者相比，这些患者在中毒时的碳氧血红蛋白、降钙素原和肌钙蛋白 I 水平显著更高。Logistic 回归分析显示，年龄、碳氧血红蛋白水平、降钙素原、肌钙蛋白 1 和 CO 暴露时间与心肌梗死的风险增加相关。降钙素原、肌钙蛋白和碳氧血红蛋白水平对预测心肌梗死的发生具有较高的敏感性和特异性，ROC 曲线下面积较高。
在 CO 中毒患者中，中毒时的碳氧血红蛋白、肌钙蛋白和降钙素原水平是晚期心肌梗死发生的重要预测因子。
