Suppr超能文献

甲醇中毒的心电图变化、死亡率及晚期表现

Electrocardiographic Changes, Mortality, and Late Period Findings in Methyl Alcohol Poisoning.

作者信息

Coskun Abuzer, Demirci Burak, Oymak Ismail, Ferhatlar Enes, Eren Sevki Hakan

机构信息

Department of Emergency Medicine, Istanbul Bagcilar Education and Research Hospital, Istanbul 34200, Turkey.

Department of Emergency Medicine, Faculty of Medicine, Gaziantep University, Gaziantep 27310, Turkey.

出版信息

J Clin Med. 2024 Oct 8;13(19):5999. doi: 10.3390/jcm13195999.

Abstract

: Methyl alcohol poisoning (MAP) is a common commercial compound that can lead to significant morbidity and mortality when exposed to high levels. This study aims to describe MAP-related electrocardiography (ECG) changes and post-acute late complications. : The study was conducted through a retrospective data review between 2017 and 2023. Patient data were recorded, including demographic information, medication use, and laboratory results. Twelve-lead ECG recordings were evaluated and the results were recorded. The cases included in the study were grouped according to QTc distance, ECG findings, late-term complications, treatment status, and mortality. : The mean age of all cases included in the study (n = 227) was 43.23 ± 11.11 years, 8 (3.5%) cases were female, and the age distribution was between 19 and 68 years ( = 0.792). The age distribution of QTc groups was not significant ( = 0.792). The mean QTc distance was 442.7 ± 60.1 ms in all cases (n = 227) and 514.08 ± 5.45 ms in cases with mortality (n = 49) ( < 0.001). The mean time to application of the patients to the hospital (n = 227) was 19.1 ± 4.61 h, and blood sugar was 130.7 ± 32.09 mg/dL ( < 0.001). In addition, the mean pH of the cases (n = 227) was 7.14 ± 0.2, bicarbonate was 17.17 ± 4.86 mmol/L, the base deficit was -6.21 ± 3.18 mmol/L, the anion gap was 19.36 ± 7.31 mmol/L, and lactate was 4.82 ± 2.45 mmol/L ( < 0.001). Mortality occurred in 49 (21.6%) of the patients, and all of them were in-hospital deaths. In all cases where mortality occurred, pH was below 6.93 ± 0.22 and severe acidosis was directly related to death. MAP, sinus tachycardia in 31 (13.7%) cases, bradycardia in 8 (3.5%), atrial fibrillation in 5 (2.2%), accelerated idioventricular rhythm in 3 (1.3%), and 11 (4.8%), left bundle branch block, and right bundle branch block were detected in 22 (9.7%). All of these ECG findings were newly developed conditions with no previous history. In the 6-month follow-up after discharge, 4 (1.8%) of the cases developed neurological deficit, 15 (6.6%) had acute coronary syndrome and severe heart failure, 23 (10.1%) had permanent blindness, 6 (2.7%) had renal failure, and 6 (2.7%) had pancreatitis. : Methyl alcohol poisoning can cause various ECG changes; sinus tachycardia, nonspecific changes, and QTc prolongation are the most common findings. These changes are more pronounced in cases of severe acidosis. Patients should be warned of late signs of MAP.

摘要

甲醇中毒(MAP)是一种常见的商业化合物,高剂量接触时可导致严重的发病和死亡。本研究旨在描述与MAP相关的心电图(ECG)变化及急性后期并发症。

本研究通过回顾2017年至2023年的数据进行。记录患者数据,包括人口统计学信息、用药情况和实验室检查结果。评估12导联心电图记录并记录结果。根据QTc间期、心电图表现、后期并发症、治疗情况和死亡率对纳入研究的病例进行分组。

本研究纳入的所有病例(n = 227)的平均年龄为43.23±11.11岁,8例(3.5%)为女性,年龄分布在19至68岁之间(P = 0.792)。QTc分组的年龄分布无显著差异(P = 0.792)。所有病例(n = 227)的平均QTc间期为442.7±60.1毫秒,死亡病例(n = 49)的平均QTc间期为514.08±5.45毫秒(P < 0.001)。患者到院的平均时间(n = 227)为19.1±4.61小时,血糖为130.7±32.09毫克/分升(P < 0.001)。此外,病例(n = 227)的平均pH值为7.14±0.2,碳酸氢盐为17.17±4.86毫摩尔/升,碱缺失为-6.21±3.18毫摩尔/升,阴离子间隙为19.36±7.31毫摩尔/升,乳酸为4.82±2.45毫摩尔/升(P < 0.001)。49例(21.6%)患者死亡,均为院内死亡。在所有发生死亡的病例中,pH值均低于6.93±0.22,严重酸中毒与死亡直接相关。MAP患者中,31例(13.7%)出现窦性心动过速,8例(3.5%)出现心动过缓,5例(2.2%)出现心房颤动,3例(1.3%)出现加速性室性自主心律,11例(4.8%)出现左束支传导阻滞,22例(9.7%)出现右束支传导阻滞。所有这些心电图表现均为新出现的情况,既往无相关病史。出院后6个月的随访中,4例(1.8%)病例出现神经功能缺损,15例(6.6%)发生急性冠状动脉综合征和严重心力衰竭,23例(10.1%)出现永久性失明,6例(2.7%)出现肾衰竭,6例(2.7%)出现胰腺炎。

甲醇中毒可导致各种心电图变化;窦性心动过速、非特异性改变和QTc延长是最常见的表现。这些变化在严重酸中毒病例中更为明显。应向患者警示MAP的后期体征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/874e/11478394/c8d0b93e4b30/jcm-13-05999-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验