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使用先进的心电图分析预测埃及亚历山大急性一氧化碳中毒患者肌钙蛋白 I 和 N 末端脑利钠肽前体水平。

Prediction of troponin I and N-terminal pro-brain natriuretic peptide levels in acute carbon monoxide poisoning using advanced electrocardiogram analysis, Alexandria, Egypt.

机构信息

Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Cardiology and Angiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

出版信息

Environ Sci Pollut Res Int. 2021 Sep;28(35):48754-48766. doi: 10.1007/s11356-021-14171-3. Epub 2021 Apr 30.

Abstract

The study aimed at assessing the diagnostic ability of advanced electrocardiogram (ECG) analysis to predict the levels of NT-proBNP and Troponin I. ECG and the blood NT-proBNP and Troponin I were taken from 50 acutely carbon monoxide poisoned patients and 21 control subjects matched with age and sex. The severity of the studied cases was classified into mild, moderate, and severe using clinical classification. ECG parameters (RR interval, corrected QT (QTc) interval, P wave dispersion (Pwd)), and cardiac biomarkers (NT-proBNP and Troponin I) were significantly higher in cases than in control (p= 0.015, 0.008, 0.002, <0.001, and <0.001 respectively). Cut-off values resulted from combined ROC curves analysis can predict blood Troponin I more than 0.05 ng/ml and NT-proBNP more than 125 pg/ ml (with 88% and 84% accuracy respectively). In addition, two regression equations were developed using all studied ECG parameters to predict Troponin I and NT-proBNP (with 68% and 43% accuracy respectively). RR average, PR average, QRS average, QTd, QTc, and Pwd could be used to predict Troponin I and NT-proBNP levels with good accuracy in carbon monoxide poisoning patients.

摘要

这项研究旨在评估高级心电图(ECG)分析对预测 NT-proBNP 和肌钙蛋白 I 水平的诊断能力。从 50 名急性一氧化碳中毒患者和 21 名年龄和性别匹配的对照组中采集了 ECG 和血液 NT-proBNP 和肌钙蛋白 I。使用临床分类将研究病例的严重程度分为轻度、中度和重度。与对照组相比,病例组的心电图参数(RR 间期、校正 QT(QTc)间期、P 波离散度(Pwd))和心脏生物标志物(NT-proBNP 和肌钙蛋白 I)显著升高(p=0.015、0.008、0.002、<0.001 和 <0.001)。联合 ROC 曲线分析得出的截断值可以预测血液肌钙蛋白 I 超过 0.05ng/ml 和 NT-proBNP 超过 125pg/ml(准确性分别为 88%和 84%)。此外,使用所有研究的 ECG 参数开发了两个回归方程来预测肌钙蛋白 I 和 NT-proBNP(准确性分别为 68%和 43%)。RR 平均、PR 平均、QRS 平均、QTd、QTc 和 Pwd 可用于预测一氧化碳中毒患者的肌钙蛋白 I 和 NT-proBNP 水平,具有良好的准确性。

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