前列地尔注射液对急性重度有机磷农药中毒患者的心肌保护效果  

Analysis of alprostadil injection on myocardial protection in patients with acute severe organophosphorus pesticide poisoning

作　　者：李永胜[1] 杨蓉佳[1] 张世魁[1] 冯友繁[1] 曲强[1] 张秀英[1] 

机构地区：[1]甘肃省人民医院急诊中心,甘肃兰州730000

出　　处：《临床荟萃》2015年第9期981-984,共4页Clinical Focus

基　　金：国家自然科学基金资助课题(30571570)

摘　　要：目的探究急性重度有机磷农药中毒患者中使用前列地尔注射液治疗的心肌保护效果,为提高患者的治疗质量提供指导依据。方法选择2012年7月至2014年4月我院收治的急性重度有机磷农药中毒患者106例,采用随机数字表法分成观察组与对照组,每组均53例,对照组进行常规治疗及阿托品、解磷定等特效治疗,观察组在对照组基础上使用前列地尔注射液治疗,比较两组患者的治疗效果。结果观察组治疗总有效率94.3%(50/53),显著高于对照组71.7%(38/53),差异有统计学意义(P<0.01);观察组治疗3天后、7天后的肌钙蛋白I(cTn-I)、肌酸激酶同工酶(CK-MB)等指标水平及心电图异常发生率均显著低于对照组患者,且观察组患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室质量指数(LVMI)等心脏形态结构指标水平均显著低于对照组患者,差异有统计学意义(P<0.05);两组患者均未发生严重的不良反应症状。结论在急性重度有机磷农药中毒患者中使用前列地尔注射液治疗,能够有效保护患者的心肌功能,药疗安全性高,具有较高的临床推广价值。Objective To explore the myocardial protective effect of alprostadil injection in patients with acute severe organophosphorus pesticide poisoning and to provide data for improving the quality of patient care. Methods A total of 106 patients with severe organic phosphorus pesticide poisoning were randomly divided into observation group （53 cases） and control group （53 cases）. Control group was treated with conventional treatment, atropine and pralidoxime and observation group was treated conventional treatment, atropine, pralidoxime and alprostadil injection. Treatment effect was sobserved between two groups. Results Total effective rate of 94.3% in the observation group was significantly higher than that of 71.7% in control group （P 〈0.0l）. On the third and seventh day after treatment, the levels of cTn-I, and CK MB and the incidence of abnormal electrocardiogram were significantly lower in observation group than in control group, and LVEDD, LVESD, LVMI and other cardiac structure indexes were significantly lower in observation group than in control group （ P 〈0.05） ; No serious adverse reactions took place in this study. Conclusion Alprostadil injection can effectively and safely protect the myocardial function in patients with severe organic phosphorus pesticide poisoning and is worth to be popularized.

关 键 词：中毒 有机磷化合物 前列地尔 心肌保护 

分 类 号：R595.9[医药卫生—内科学]