乌司他丁对急性重度一氧化碳中毒患者心肌损害的效果  

Effect of ulinastatin on myocardial injury in patients with acute severe carbon monoxide poisoning

作　　者：王璞[1] 李伟[1] 杨俊礼 王岩[1] 刘倩[1] 王维展[1] 齐洪娜[1] 李锦[2] Wang Pu;Li Wei;Yang Junli;Wang Yang;Liu Qian;Wang Weizhan;Qi Hongna Li Jin(Emergency Department of Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui 053000, Chin)

机构地区：[1]河北省衡水市哈励逊国际和平医院急诊科,053000 [2]河北省衡水市哈励逊国际和平医院神经功能检查科

出　　处：《中华劳动卫生职业病杂志》2018年第2期154-156,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的观察乌司他丁对急性重度一氧化碳中毒（ASCOP）患者心肌损害的疗效。方法采用前瞻性研究方法，将收治的123例ASCOP患者，按随机原则分为对照组和观察组，两组入院时心电图异常率、脑钠肽（BNP）、肌钙蛋白I（cTNI）、肌酸激酶同工酶（CK-MB）、肌酸激酶（CK）均无明显差异。对照组根据患者病情需要给予高压氧、常规内科治疗；观察组在常规治疗措施基础上加用乌司他丁10万单位静脉滴注，每8 h 1次，两组均14 d为1个疗程。比较两组患者治疗后3、7、14 d心电图异常率、BNP、cTNI、CK-MB、CK水平及异常率、14 d病死率的差异。结果观察组治疗3、7 d心电图异常率、BNP、cTNI、CK-MB、CK水平及异常率均明显低于对照组，差异有统计学意义（P〈 0.05）；观察组治疗14 d BNP水平明显低于对照组，差异有统计学意义（P〈0.05）；观察组14 d病死率（1.2%）低于对照组（3.3%），差异有统计学意义（P〈0.05）。结论乌司他丁能显著减轻ASCOP患者的心肌损害，降低病死率，改善预后。ObjectiveTo observe the effect of ulinastatin on myocardial injury in patients with acute severe carbon monoxide poisoning（ASCOP）.MethodsBy using the prospective study method,123 cases of ASCOP patients admitted to our hospital,were randomly divided into two groups.There were no significantly different between the two groups in the abnormal rates of ECG,brain natriuretic peptide（BNP）,troponin I（cTNI）,creatine phosphokinase（CK-MB）and creatine phosphokinase（CK）.The control group according to the patients need to be treated with hyperbaric oxygen and routine medical treatment;the observation group was treated with ulinastatin 100 thousand u intravenous injection based on routine treatment measures on Q8 h,the two groups were 7 d for the 1 course of treatment.Compared two groups of patients after 3 days,7 days of electrocardiogram,brain natriuretic peptide（BNP）,troponin I（cTNI）,creatine kinase isoenzyme（CK-MB）,creatine kinase（CK）,the case fatality rate within 14 days,and the abnormality rate of BNP,cTNI,CK-MB and Ck.Resultsthe observation group for 3 days,7 days,14 days were abnormal,brain natriuretic peptide（BNP）,cardiac troponin I（cTNI）,creatine kinase isoenzyme（CK-MB）,creatine kinase（CK）the average results were significantly lower than those in the control group（P〈0.05）;The 14 d BNP in the observation group was significantly lower than the control group（P〈0.05）;the case fatality rateof observation group was lower than the control group within 14 days（1.2% vs 3.3%）. ConclusionUlinastatin can significantly improve the ASCOP to reduce the damage to the heart,reduce the case fatality rateand improve the prognosis.

关 键 词：乌司他丁 急性一氧化碳中毒 心肌损害 预后 

分 类 号：R595.1[医药卫生—内科学]