连续性床旁血液滤过联合解磷定VitB6对急性有机磷农药中毒患者的效果及对心肌损伤炎症症状的影响  

Effect of Continuous Bedside Hemofiltration Combined with Desmophosphate and VitB6 on Patients with Acute Organophosphorus Pesticide Poisoning and the Effect on Myocardial Injury and Inflammatory Symptoms

作　　者：王亚红[1] 范迎宾[1] 李默莎 尤建林 沈薇[2] WANG Yahong;FAN Yingbin;LI Mosha(Jiuquan People's Hospital,Gansu Jiuquan 735000,China)

机构地区：[1]甘肃省酒泉市人民医院急救中心,甘肃酒泉735000 [2]甘肃省医学科学研究院药物研究所,甘肃兰州730050

出　　处：《河北医学》2023年第3期461-466,共6页Hebei Medicine

基　　金：2017甘肃省级中医药科研课题,(编号:GZK-2017-44)。

摘　　要：目的:探讨连续性床旁血液滤过联合解磷定、维生素B6(VitB6)治疗急性有机磷农药中毒的临床效果。方法:选取2018年3月至2022年4月在我院治疗的急性有机磷农药中毒患者92例,采用掷硬币法将患者随机分为观察组(n=46)和对照组(n=46),对照组给予连续性床旁血液滤过等治疗,观察组在对照组基础上联合解磷定、VitB6治疗,观察两组阿托品用量和住院时间等差异,同时分析治疗前后心肌酶谱等指标差异。结果:观察组阿托品用量和住院时间明显少于对照组(P<0.05)。观察组胆碱酯酶(ChE)和超氧化物歧化酶(SOD)和丙二醛(MDA)治疗前后差值明显高于对照组(P<0.05)。观察组肌酸激酶同工酶MB(CK-MB)、肌酸激酶(CK)、肌钙蛋白(cTnI)、天门冬氨酸氨基转移酶(AST)、脑钠肽(BNP)和肌红蛋白(MYO)治疗前后差值明显高于对照组(P<0.05)。观察组C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)和白细胞介素-8(IL-8)分治疗前后差值明显高于对照组(P<0.05)。结论:连续性床旁血液滤过联合解磷定、VitB6治疗急性有机磷农药中毒有较好的临床效果,具有促进心肌损伤恢复,降低炎症水平等优点。Objective:To explore the clinical effect of continuous bedside hemofiltration combined with antiphosphoridine and vitamin B6(VitB6)in the treatment of acute organophosphorus pesticide poisoning.Methods:92 patients with acute organophosphorus pesticide poisoning treated in our hospital from March 2018 to April 2022 were randomly divided into the observation group(n=46)and the control group(n=46),the control group was given continuous bedside hemofiltration treatment,and the observation group was treated with jiefosidine and VitB6 on the basis of the control group.The differences in atropine dosage,mechanical ventilation time and hospitalization time between the two groups were observed,and the differences of myocardial enzyme spectrum and so on before and after treatment were analyzed.Results:The atropine dosage,and hospitalization time in the observation group were significantly less than those in the control group(P<0.05).The difference before and after treatment of cholinesterase(ChE),superoxide dismutase(SOD)and malondialdehyde(MDA)in the observation group were significantly higher than that in the control group(P<0.05).The difference before and after treatment of creatine kinase isoenzyme MB(CK-MB),creatine kinase(CK),troponin(cTnI),aspartate aminotransferase(AST),brain natriuretic peptide(BNP)and myoglobin(MYO)in the observation group were significantly higher than those in the control group(P<0.05).The difference before and after treatment of C-reactive protein(CRP),tumor necrosis factor(TNF-α)and interleukin-8(IL-8)in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Continuous bedside hemofiltration combined with desmophosphate and VitB6 has a good clinical effect in the treatment of acute organophosphorus pesticide poisoning,has the advantages of promoting the recovery of myocardial injury and reducing the level of inflammation.

关 键 词：连续性床旁血液滤过 解磷定 维生素B6 急性有机磷农药中毒 临床效果 

分 类 号：R595.4[医药卫生—内科学]