毒鼠强浓度在人体内变化规律研究  

Study on the variation in blood concentration of tetramine in human body.

作　　者：曹艳平[1] 陈金东[1] 李蔚[1] 王大威[1] 张霞[1] 

机构地区：[1]山东省疾病预防控制中心理化检验所 ,济南250014

出　　处：《中国综合临床》2009年第7期692-694,共3页Clinical Medicine of China

基　　金：山东省医药卫生科研项目（2005HZ070）

摘　　要：目的探讨3种方法治疗急性毒鼠强中毒后不同时期患者体内毒鼠强浓度的改变及出院后正常生活条件下毒鼠强浓度变化。方法用气相色谱-质谱分析患者血液中毒鼠强浓度，根据101例患者血液中毒鼠强浓度高低和临床症状分为常规综合治疗组、加行血液灌流组、加行输血治疗组，监测其治疗前后体内毒鼠强浓度变化，对出院患者进行为期1年的跟踪随访，检测其体内毒鼠强浓度变化。结果常规综合治疗组治疗后毒鼠强浓度由治疗前33．0（1．7—115．0）μg/L下降为18．0（0．3—47．6）μg/L，平均下降45．5％；加行血液灌流组由治疗前108．0（54．0～290．0）μg/L经多次血液灌流后下降为26．0μg/L，末次血液灌流后较血液灌流前下降75．9％，每次血液灌流后下降20．0％-45．0％，血液灌流24h后毒鼠强浓度略有回升现象；加行输血治疗患者2例，治疗后毒鼠强浓度分别下降33．5％及60．0％。25例出院患者在中毒6个月时有2例体内仍含有毒鼠强，且仍以化学原形存在，随访1年时均未再检出毒鼠强。结论常规综合治疗、血液灌流、输血治疗毒鼠强中毒是积极有效的方法，毒鼠强在人体内代谢缓慢。Objective To study the variation of blood concentration of tetramine in human body with acute tetramine intoxication treated with three different protocols and the levels in human body after discharge from the hospital. Methods The blood concentration of tetramine was determined by gas chromatography-mass spectrometry （GC-MS）. All 101 patients of acute tetramine intoxication were divided into 3 groups （routine comprehensive treatment group,hemoperfusion group, blood transfusion group） according to their blood concentration of tetramine and clinical symptoms. The patients were followed up to monitor the tetramine levels in a year. Results The level of tetramine in blood was decreased from 33.0 （ 1.7 - 115.0） μg/L to 18.0 （0.3 -47.6） μg/L in routine comprehensive treatment group. The total decrement was 45.5 %. The level was decreased from 108.0 （54.0 -290.0） μg/L to 26.0 μg/L in hemoperfusion group. The total decrement was 75.9%. The decrement was 20.0% - 45.0% after each hemoperfusion. The level was slightly high after 24 h of hemoperfusion. The total deerement in blood transfusion group was 33.5 % -60.0%. The level was 〈 0.3 μg/L in all 25 out-patients 1 year after their intoxication. Conclusion Routine comprehensive treatment, hemoperfusion, blood transfusion are effective in the treatment of acute tetramine intoxication. The degradation of tetramine in human body is slow.

关 键 词：毒鼠强 中毒 常规综合治疗 血液灌流 输血 

分 类 号：R595.4[医药卫生—内科学] R151.2[医药卫生—临床医学]