早期高压氧联合吡拉西坦治疗对急性一氧化碳中毒患者肝肾功能及心肌酶谱的影响  

Effects of early hyperbaric oxygen combined with piracetam on hepatic and renal function and myocardial enzyme spectrum in patients with acute carbon monoxide poisoning

作　　者：李静[1] 刘琳 谷琳琳[1] 郭鲁恒 王桥生[4] 郭向杰[1] Li Jing;Liu Lin;Gu Linlin;Guo Luheng;Wang Qiaosheng;Guo Xiangjie(Emergency Department,Affiliated Hospital of Jining Medical University,Jining 272100,China)

机构地区：[1]济宁医学院附属医院急诊科,山东省济宁272100 [2]济宁医学院附属医院健康管理中心,山东省济宁272100 [3]济宁医学院附属医院重症监护室三区,山东省济宁272100 [4]湖南南华大学附属第一医院重症医学科

出　　处：《中华航海医学与高气压医学杂志》2021年第5期594-598,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：湖南省自然科学基金面上项目(2017J2229)。

摘　　要：目的探讨早期高压氧联合吡拉西坦治疗对急性一氧化碳中毒(ACOP)患者肝肾功能及心肌酶谱的影响。方法选取2015年1月至2019年1月济宁医学院附属医院急诊科103例ACOP患者为研究对象,按治疗方法分为对照组(高压氧治疗)53例和观察组(高压氧联合吡拉西坦治疗)50例,比较2组患者肾功能、心肌酶谱、超氧化物歧化酶、肝功能、临床疗效和不良反应发生率。结果观察组治疗总有效率(98.00%)高于对照组(79.25%),差异有统计学意义(P<0.05);观察组患者治疗后血尿素氮、血肌酐、尿酸、β2微球蛋白、肌酸激酶、肌酸激酶同工酶、α-羟丁酸脱氢酶、乳酸脱氢酶、碱性磷酸酶、丙氨酸转氨酶、天冬氨酸转氨酶水平低于对照组,超氧化物歧化酶水平高于对照组,差异均有统计学意义(P<0.05);2组患者迟发性脑病、急性脑梗死、横纹肌溶解、压疮等不良反应发生率差异无统计学意义(P>0.05)。结论早期高压氧联合吡拉西坦治疗ACOP患者临床效果显著,可改善缺氧导致的心肌损伤,对保护肝肾功能具有积极作用。Objective To investigate the effects of early hyperbaric oxygen combined with piracetam on hepatic and renal function and myocardial enzyme spectrum in patients with acute carbon monoxide poisoning(ACOP).Methods A total of 103 patients with ACOP treated in the Emergency Department of Affiliated Hospital of Jining Medical University from January 2015 to January 2019 were selected and divided into control group(53 cases,hyperbaric oxygen treatment)and observation group(50 cases,hyperbaric oxygen combined with piracetam treatment).The changes in the renal function,myocardial enzyme spectrum,superoxide dismutase(SOD),and the hepatic function,as well as the clinical efficacy,and the incidences of adverse reactions were compared between the two groups.Results The total effective rate of the observation group(98.00%)was significantly higher than that of the control group(79.25%),and there was a statistically significant difference(P<0.05).After treatment,the levels of blood urea nitrogen(BUN),creatinine(Cr),uric acid,β2 microglobulin(β2-MG),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),α-hydroxybutyrate dehydrogenase(α-HBDH),lactate dehydrogenase(LDH),alkaline phosphatase(ALP),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)in the observation group were lower than those in the control group,while the level of SOD in the observation group was higher than that in the control group,and there were statistically significant differences(P<0.05).In terms of the incidences of delayed encephalopathy,acute cerebral infarction,rhabdomyolysis,and pressure ulcer,there was no statistically significant difference between the two groups(P>0.05).Conclusion The early hyperbaric oxygen combined with piracetam has a significant clinical efficacy in treating patients with ACOP.It can alleviate the myocardial damage caused by hypoxia,and plays a positive role in protecting hepatic and renal function.

关 键 词：高压氧 吡拉西坦 急性一氧化碳中毒 肾功能 肝功能 心肌酶谱 

分 类 号：R595.1[医药卫生—内科学]