曲美他嗪联合川芎嗪对急性有机磷中毒后心肌损伤的保护作用研究  

Protective effects of trimetazidine and ligustrazine onmyocardium damage of acute or- ganic phosphorus poisoning patients

作　　者：文道清 曾建文[1] 杨华涛[1] 李彤明[1] 林珊姝 

机构地区：[1]广东省揭西县棉湖华侨医院急诊科 ,515438

出　　处：《国际医药卫生导报》2010年第4期456-459,共4页International Medicine and Health Guidance News

摘　　要：目的研究曲美他嗪联合川芎嗪注射液对急性有机磷农药中毒致心肌损伤的保护作用及其机制。方法41例急性有机磷农药中毒患者，其中轻度中毒者13例、中度中毒者13例、重度中毒者15例。按随机分层原则分为常规治疗组（A组）22例，常规治疗＋曲美他嗪联合川芎嗪注射液组（B组）19例。采用动力学法，分别对肌酸激酶（cK）、肌酸激酶同功酶（CK—MB）、乳酸脱氢酶（LDH），放射免疫测定法对cTnI（心肌肌钙蛋白I）测定血浆中的生化指标水平；心电图检查，采用床旁心电图监测；观察上述各组指标冶疗前后动态变化情况，并对相关机理进行探讨。结果入院6小时A、B两组血浆生化指标均有升高，但组间指标差异无显著性fP〉0．05），治疗48h，A组血生化指标增长高于B组，差异有显著性（P〈0．05），治疗7天后，病人上述指标基本恢复到接近正常范围。床旁24h动态心电图检测，A组出现严重心电图异常的几率较B组更显著。结论曲美他嗪联合川芎嗪注射液对急性有机磷农药中毒致心肌损伤具有显著保护作用。Objective To investigate the protective effects of Trimetazidine and Ligustrazine Injection on myocardium damage caused by acute organic phosphorus poisoning. Methods 41 acute organophosphate poisoning patients including 13 cases of mild - poisoning, 13 cases of midrange poisoning and 15 cases of severe poisoning were randomly divided into two groups ： group A（conventional therapy group, n= 22）, group B（conventional therapy＋Trimetazidine and Ligustrazine Injection therapy group, n=19）, plasma levels of creatine kinase （CK）, creatine kinase isoenzymeMB （CK-MB）, lactate dehydroge- nase （LDH） were measured by dynamic method and plasma levels of Myocardium troponin I （cTnl） were measured by radioimmunoassav（RIA）. Electrocardiograms were monitored at bedside. The dynamic change of indicators were observed and pathogenesis was discussed. Results Be in hospital 6 hours , Plasma levels of biochemical indicators were increased in both two groups. There is no significantly difference between group A and B （ P〉0. 05）. 48 hours after treatment, plasma levels of biochemical indicators in group A were significantly higher than that in group B（P〈0.05）.Severity abnormal appearance of Electrocardio- grams in group A were also significantly higher than that in group B. Seven days after treatment, plasma levels of such indicators were near to normal. Conclusion Trimetazidine and Ligustrazine Injection have protective effects on the myocardium damage caused by acute organic phosphorus.

关 键 词：中毒 有机磷农药 急性 曲美他嗪 川芎嗪 心肌损伤 

分 类 号：R595.4[医药卫生—内科学] R277.733.3[医药卫生—临床医学]