Application of two indexes in the evaluation of carbon monoxide toxic heart disease / 中华急诊医学杂志

ABSTRACT

Objectives:To investigate the relationship between heart rate adjusted QT dispersion (QTcd) and soluble growth stimulating gene 2 protein (sST2) and the severity and prognosis of patients with acute carbon monoxide toxic heart disease.Methods:Retrospective analysis was performed on 135 patients with acute carbon monoxide toxic heart disease admitted to the Emergency Medical Department of our hospital from January 2017 to 2020. Blood sST2, creatine kinase isoenzyme (CK-MB) and troponin I(cTnI) concentrations were recorded at 3 h, 12 h, 2 d and 3 d immediately after admission.The patient was measured and calculated on the day of admission,2 d,3 d and QTcd at discharge.According to the toxicity of carbon monoxide in heart disease severity was divided into mild heart disease group (58 cases), moderate heart disease group (45 cases), severe heart disease group (32 cases), according to whether severe heart disease were divided into severe group (32 cases) and non severe group (103 cases), according to whether the patients death in patients with severe heart disease.Results:Thirty-two of the 135 patients had severe toxic heart disease, with an incidence of 23.7%.In the severe group, sST2, cTnI and CK-MB increased from 24 h and 2 d after admission, and the detected values were all higher than those of the non-severe group and the normal control group, with statistically significant differences ( P<0.05).Before treatment, there were statistically significant differences in sST2 and QTcd between the toxic group and the non-severe group and the normal control group ( P<0.05).After 2 d and 3 d poisoning, there were statistically significant differences between the two groups ( P<0.05). ROC curve analysis showed that the area under the sST2 curve was 0.726, 95% CI was 0.555-0.898, sensitivity was 56.3%, specificity was 94.1%, and truncation was 88.5 ng/mL.The area under the QTcd curve was 0.745, 95% CI was 0.602-0.889, sensitivity was 56.3%, specificity was 82.4%, and truncation value was 68.5 ms.The area under the combined detection curve was 0.939, 95% CI was 0.874-1.000, sensitivity was 81.3%, specificity was 91.2%. Conclusions:In patients with acute carbon monoxide toxic heart disease, the level of sST2 increased earlier than THAT of cTnI and CK-MB, and the combined observation of sST2 and QTcd can be used as an indicator for early prediction of acute carbon monoxide toxic heart disease and its severity.