早期血液灌流对急性有机磷农药中毒患者血清ALT、cTnI和AMS水平的影响  

Effects of early hemoperfusion on levels of serum ALT,cTnI and AMS in patients with acute organophosphorus pesticide poisoning

作　　者：蔡婷婷[1] 陶宁[1] 涂贵新 蔡国容 胡建平[1] CAI Tingting;TAO Ning;TU Guixin;CAI Guorong;HU Jianping(Department of Emergency,Suining Central Hospital,Suining 629000,Sichuan,China)

机构地区：[1]遂宁市中心医院急诊科,四川遂宁629000

出　　处：《西部医学》2022年第5期748-752,共5页Medical Journal of West China

基　　金：四川省基层卫生事业发展研究中心2017年立项项目(SWFZ17-Y-39)。

摘　　要：目的探究早期血液灌流(HP)对急性有机磷农药中毒(AOPP)患者血清丙氨酸氨基转移酶(ALT)、肌钙蛋白I(cTnI)、淀粉酶(AMS)水平的影响。方法回顾性分析2016年4月~2020年4月于我院接受治疗的120例AOPP患者,分为研究组61例与对照组59例。对照组在中毒6 h后予以HP治疗,研究组在中毒6 h内予以HP治疗。比较两组患者治疗前及治疗24 h后血清指标、血清炎症因子水平变化差异,比较两组患者治疗情况、并发症发生差异。结果治疗24 h后,两组患者ALT均较治疗前下降,且研究组低于同期对照组(P<0.05);研究组患者cTnI、AMS均较治疗前下降,对照组患者cTnI、AMS均较治疗前上升,且研究组低于同期对照组(P<0.05);两组患者IL-6、TGF-β1、CRP水平较治疗前均下降,且研究组低于对照组(P<0.05);研究组患者阿托品用量、ChE恢复正常时间、昏迷时间均低于对照组(P<0.05);治疗后,两组患者并发症发生率及治疗结局差异不显著(P>0.05)。结论早期HP治疗AOPP对降低患者ALT、cTnI、AMS及血清炎症因子水平效果显著,且能有效缓解患者症状,对患者并发症影响不显著。Objective To explore the effects of early hemoperfusion(HP)on levels of serum alanine aminotransferase(ALT),cardiac troponin I(cTnI)and amylase(AMS)in patients with acute organophosphorus pesticide poisoning(AOPP).Methods The clinical data of 120 patients with AOPP who were treated in the hospital between April 2016 and April 2020 were retrospectively analyzed,and the patients were divided into study group(n=61)and control group(n=59).The control group was treated with Hp at 6h after poisoning,and the study group was given Hp within 6h after poisoning.The levels of serum indexes(ALT,cTnI,AMS)and serum inflammatory factors[interleukin-6(IL-6),transforming growth factor-β1(TGF-β1),C-reactive protein(CRP)]were compared between the two groups before treatment and after 24 h of treatment.The treatment status(atropine dosage,cholinesterase(ChE)normal recovery time,coma time)and occurrence of complications were compared between the two groups.Results After 24 h of treatment,the ALT level of the two groups was decreased compared with that before treatment,and the level in study group was lower than that in control group during the same period(all P<0.05).The levels of cTnI and AMS in study group were decreased compared with those before treatment while the levels of cTnI and AMS in control group were increased compared with those before treatment,and the levels in study group were lower than those in control group during the same period(all P<0.05).The levels of IL-6,TGF-β1 and CRP of the two groups were decreased compared with those before treatment,and the levels in study group were lower than those in control group(all P<0.05).The atropine dosage,ChE normal recovery time and coma time in study group were less or shorter than those in control group(all P<0.05).After treatment,there were no significant differences in the incidence rates of complications and treatment outcomes between the two groups(all P>0.05).Conclusion Early HP treatment of AOPP has significant effects on reducing the levels of ALT,cTnI,AMS and ser

关 键 词：早期血液灌流 急性有机磷中毒 ALT CTNI 血清炎症因子 

分 类 号：R595.4[医药卫生—内科学]