纳络酮对重度急性有机磷农药中毒患者血浆一氧化氮水平的影响  

Effects of naloxone on the changes of nitrogen monoxide in patients with severe acute organophosphorus pesticide poisoning.

作　　者：杨慎启[1] 房体坤[1] 李娟[1] Yang Shenqi, Fang Tikun, Li Juan. （ The first people＇s hospitol of Jining, Shandong 272011, China ）

机构地区：[1]济宁市第一人民医院,山东济宁272011

出　　处：《中国保健》2009年第26期1097-1098,共2页

摘　　要：目的：观察重度急性有机磷农药中毒（AOPP）患者血浆NO水平的变化及纳络酮对其影响。方法：56例重度AOPP患者随机分为对照组和治疗组各28例，治疗组在常规治疗的基础上加用纳络酮治疗，分别于入院后即刻、中毒后12、24、72、120h抽静脉血2ml，采用硝酸还原法测定NO，并以20例健康者为正常组。结果：对照组和治疗组治愈者血浆NO水平与正常组比较在入院后即刻均已有显著性升高（P〈0．01），对照组血浆NO水平于中毒后12h达高峰，随后缓慢下降，治疗组在纳络酮治疗24h后，血浆NO水平明显降低，120h几乎降至正常，与对照组比较差异有显著性（P〈0．01）；4例死亡患者血浆NO水平在入院后即刻已有非常显著性升高，在治疗过程中继续升高。结论：NO可能参与AOPP的病理生理过程，而且与病情转归有关，血浆NO水平稳定下降提示预后良好，持续升高则提示预后不良；纳络酮可明显降低重度AOPP患者血浆NO水平，改善其预后。Objective： To investigate effects of naloxone on the changes of nitrogen monoxide in patients with severe acute organophosphorus pesticide poisoning（ AOPP）. Methods ：56 cases of severe AOPP patients were randomly divided into 2 groups： naloxone group（ n = 28 ） was given naloxone plus routine treatment, the other group as control group （ n = 28 ）, and was treated with routine treatment, at same time, 20 healthy subjects were recruited as normal control. The blood samples were taken from patients upon hospitalization and 12h ,24h ,72h, 120h after poisoning, respectively, and the levels of NO were measured by reductive nitric acid. Results： Compared with normal group, the plasma levels of NO were significantly rising in patients of 2 groups who were cured upon hospitalization （P 〈 0. 01 ）, with the peak values at 12h after poisoning,then slowly decreased along with time in the control group. The levels of NO in treatment group were lower significantly after being given naloxone 24h, and almost reached normal level at 120h, compared with control group（ P 〈 0. 01 ）. The levels of NO from 4 died patients were very high upon hospitalization and continued to increase in the course of whole treatment. Conclusion ： NO may be involved in the pathogenesis of AOPP, and the levels of NO are correlated with the severity and the patient＇s condition of AOPP. The levels of NO decrease gradually to display eusemia in the course of treatment, on the contrary, their levels increase gradually to display mal - prognosis. Naloxone may decrease the level of NO and prove the prognosis significantly of severe AOPP.

关 键 词：重度 急性 有机磷农药中毒 一氧化氮 纳络酮 

分 类 号：R595.4[医药卫生—临床医学;医药卫生—内科学]