QTc间期延长表明有机磷中毒患者预后不良。

QTc prolongation indicates a poor prognosis in patients with organophosphate poisoning.

作者信息

Chuang F R, Jang S W, Lin J L, Chern M S, Chen J B, Hsu K T

机构信息

Poison Center, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.

出版信息

Am J Emerg Med. 1996 Sep;14(5):451-3. doi: 10.1016/S0735-6757(96)90148-5.

DOI:10.1016/S0735-6757(96)90148-5

PMID:8765106

Abstract

This study reviewed emergency department electrocardiograms of 223 patients with organophosphate poisoning from January 1982 to June 1994: 97 (43.5%) had QTc prolongation and were placed in group A; 126 patients without QTc prolongation were designated as group B. Compared with group B, group A patients had a higher mortality (19.6% v 4.8%, P < .001) and a higher incidence of respiratory failure (56.7% v 20.6%, P < .001). Serum cholinesterase levels were determined in the 223 patients: 92 (41.3%) were classified as severe poisoning. 32 (14.3%) as moderate, 41 (18.1%) as mild, and 58 (25.7%) as very mild. The severe group had a high incidence of QTc prolongation (P < .001), a high incidence of respiratory failure (P < 0.001), and a higher mortality rate (P < 0.001) than the other groups. Of the QTc prolongation patients, 59.8% (55/92) had a high incidence of respiratory failure (78.2% v 35.1%, P < .0001) and a higher mortality rate (29.1% v 8.1%, P < 0.05) compared with 40.2% (37/92) of the patients without QTc prolongation in the severe group. In conclusion, a complete electrocardiogram at the emergency department is important and of prognostic value.

摘要

本研究回顾了1982年1月至1994年6月期间223例有机磷中毒患者的急诊科心电图：97例（43.5%）出现QTc延长，被归入A组；126例无QTc延长的患者被指定为B组。与B组相比，A组患者的死亡率更高（19.6%对4.8%，P<0.001），呼吸衰竭发生率更高（56.7%对20.6%，P<0.001）。测定了223例患者的血清胆碱酯酶水平：92例（41.3%）被归类为重度中毒，32例（14.3%）为中度中毒，41例（18.1%）为轻度中毒，58例（25.7%）为极轻度中毒。重度组QTc延长的发生率较高（P<0.001），呼吸衰竭的发生率较高（P<0.001），死亡率也高于其他组（P<0.001）。在QTc延长的患者中，59.8%（55/92）呼吸衰竭的发生率较高（78.2%对35.1%，P<0.0001），死亡率也高于重度组中无QTc延长的40.2%（37/92）的患者（29.1%对8.1%，P<0.05）。总之，急诊科的完整心电图很重要且具有预后价值。