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1
題名:QT Interval in Patients with Acute Carbon Monoxide Poisoning: Does Carbon Monoxide Poisoning Affect QT Interval?     (16點)
一氧化碳中毒是否影響其QT值變化
著者:Chun-Chien Chiu(邱俊諫) ;Chi-Wen Juan(阮祺文) ;Ta-Lun Kao(高大倫) ;Chiu-Kuei Nien(粘秋桂) ;Yung-Zu Tseng(曾淵如)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
刊名:Journal of Emergency and Critical Care Medicine
卷期:21卷4期(2010.12)
頁碼:208-215
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

背景:一氧化碳中毒會造成直接的心肌毒性,心電圖中Q波到T波之QT間隔,反應心室去極化至再 極化化的時間,這個數值可以粗略估計整個心室平均的動作電位時間(action potential duration)。QT值的 延長是種心室傳導的疾病,可能出現在去極化或再極化的過程。曾有研究指出,一氧化碳中毒的病人, 出現QT值的延長。我們研究的目的在探討,一氧化碳中毒者,對QT值的影響,及其QT值與血中一氧化 碳血紅素濃度的關係。 方法:我們收集彰化秀傳紀念醫院急診室2004至2006年之36位一氧化碳中毒的病人分析血中一氧化 碳與血紅素結合的濃度,並做12導程的心電圖。巴列氏(Bazett’s)方程式矯正病人的QT值,再以Pearson 相關係數統計做比較。 結果:36位一氧化碳中毒者,年齡分佈在19到57歲,男性21位,女性15位。血中一氧化碳血紅素濃 度為27.6±15.2%。在異常濃度之一氧化碳環境裡,血中一氧化碳血紅素濃度與暴露時間有統計學上意 義的負相關(R=-0.367, p<0.028)。矯正後的QT值(QTc)為422.0+32.3 ms,沒有超出一般QTc的正常值 (小於440 ms)。QTc並不會隨一氧化碳血紅素濃度升高而延長。這些病人沒有發生心室性心率不整。 結論:我們的研究,沒有發現一氧化碳中毒對QT間隔的影響。我們無法僅由臨床症狀及QT間隔來 推測血中一氧化碳的濃度。據此 血中一氧化碳濃度的升高若無QT間隔的延長,其發生心室性心率不整 的機會並不高。
Background: Carbon monoxide (CO) poisoning is associated with direct cardiovascular toxicity. A prolonged QT interval has been noted in CO intoxicated patients in a few studies. The QT interval represents the time for both ventricular depolarization and repolarization, therefore roughly estimates the duration of an average ventricular action potential. A long QT interval is an arrhythmogenic condition in which there is an abnormally long delay during the electrical excitation (depolarization) and relaxation (repolarization) of the ventricles of the heart. The aim of this study was to check QTc interval prolongation in patients with acute CO poisoning and its relationship with a higher carboxyhemoglobin (COHb) level. Materials and Methods: We study 36 patients at Changhua Show Chwan Memorial Hospital ER Department during 2004-2006 who were diagnosed with CO intoxication. Blood carboxyhemoglobin and 12-lead ECG were examined on admission. Corrected QT intervals (QTcs) were calculated by Bazett’s formula. Pearson’s correlation coefficient was employed for the statistical analysis. Results: Our 36 CO intoxicated patients, aged 19-57years, consisted of 21 males and 15 females. There individuals had a mean carboxyhemoglobin levels of 27.6% ± 15.2%. There was a negative correlation between blood COHb level and exposure time (R=-.0.367, p<0.028). On admission, the QTc (422.0 ± 32.3ms) of the intoxicated patients was not significantly prolonged compared with normal (<440ms). A high COHb levels in acute CO intoxicated patients do not induce a longer QTc interval based on Pearson’s correlation coefficient analysis (R=0.122, p=0.48). Our patients had no ventricular arrhythmia. Conclusion: In this study, we were unable to detect any effect of CO poisoning on the QTc. Thus it was not possible to predict a patient’s COHb level merely from the QTc and symptoms. Accordingly, even at a high COHb levels, but in absence of QTc prolongation, the arrhythmogenic risk of acute CO poisoning is low.


    

本卷期目次
Journal of Emergency and Critical Care Medicine 21卷4期 (2010.12)
The Effect of Steroid on Post-Resuscitation Outcome in Patients with Out-of-Hospital Cardiac Arrest/ CHIH-YI LINChien-Hua HuangMin-Shan TsaiWei-Tien ChangChiung-Yuan HsuShyr-Chyr ChenWen-Jone Chen
Subcapsular Hematoma of Kidney with Rupture into the Perirenal Space After Extracorporeal Shock Wave Lithotripsy: A Case Report/ Liang-Chung HuangMeng-Chia ChenChe-Wei Hsu
Chylothorax Following Esophagectomy: Report of Two Cases/ Ming-Ho WuHan-Yun Wu
QT Interval in Patients with Acute Carbon Monoxide Poisoning: Does Carbon Monoxide Poisoning Affect QT Interval?/ Chun-Chien ChiuChi-Wen JuanTa-Lun KaoChiu-Kuei NienYung-Zu Tseng
Atypical Presentation of Ectopic Pregnancy in an Obese Woman: A Case Report/ Teck-Jin YangHO-FU HSIAOHung-Hsin Mo
An Initial Presentation of Flank Pain Caused by Thoracic Disc Herniation/ Jiun-Lang SuWei-Chean TanChih-Chung ChaoChung-Ming TsaiChao-Hsin Wu
Malposition of a Sengstaken-Blakemore Tube: A Case Report/ Mao-Heng WangMING-HUI LINTZU-YI CHUANGShih-Wei Lee
Ruptured Liver Abscess: A Rare Cause of Pneumoperitoneum/ Yuan KaoChung-Hsun ChuangWEI-JING LEEHung-Jung Lin
Acute Emphysematous Cholecystitis/ Kaung-Chau TsaiWing-Keung CheungChien-Chu LinMIN PO HO
Adult Intussusception/ Tzu-Meng YangWEI-JING LEESi-Chon Vong
Ruptured Renal Angiomyolipoma: An Unusual Cause of Flank Pain in Emergency Department/ Mung-Chee HuChu-Chung ChouChin-Fu ChangWen-Liang Chen
Coincidence of Acute Coronary Syndrome and Pulmonary Embolism in a 74-Year-Old Man/ CHEN-TUNG HSURei-Yeuh ChangCheng-Kang Chen
Early Fournier Gangrene/ JIA-SHUO TSAI(HENRY)Ren-Jen Tseng
 
   
 
   

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