葛根素注射液联合血流灌注对有机磷农药中毒患者心肌损伤及血清miR-126、miR-92a水平的影响  

Effects of puerarin injection combined with blood perfusion on myocardial injury and serum miR-126 and miR-92a levels in patients with organophosphorus pesticide poisoning

作　　者：代永龙 骆昌云 蔡东 DAI Yong-long;LUO Chang-yun;CAI Dong(Department of Intensive Care Medicine,Dazu District People's Hospital,Chongqing 402360,China;Department of Emergency Medicine,Dazu District People's Hospital,Chongqing 402360,China)

机构地区：[1]重庆市大足区人民医院重症医学科,重庆402360 [2]重庆市大足区人民医院急诊科,重庆402360

出　　处：《临床和实验医学杂志》2023年第6期590-594,共5页Journal of Clinical and Experimental Medicine

基　　金：重庆市卫生计生委中医药科技项目(编号:ZY201703037)。

摘　　要：目的探究葛根素注射液联合血流灌注对有机磷农药中毒患者心肌损伤及血清miR-126、miR-92a水平的影响。方法回顾性选取2020年7月至2022年6月于重庆市大足区人民医院就诊的102例有机磷农药中毒患者作为研究对象,根据入院时间将其分为联合组(n=56)和对照组(n=46)。对照组接受血流灌注治疗,联合组在此基础上加用葛根素注射液。比较两组患者治疗情况、治疗前后心肌损伤标志物血清肌红蛋白(Myo)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、氨基末端B型利钠肽前体(N-proBNP)和血清miR-126、miR-92a水平。结果联合组患者胆碱酯酶活性恢复至80%时间、机械通气时间、昏迷和住院时间分别为(2.16±1.20)d、(18.02±2.19)h、(12.39±2.07)h、(6.35±0.88)d,均短于对照组[(6.33±1.52)d、(21.56±3.26)h、(15.36±2.44)h、(8.62±1.59)d],阿托品和碘解磷定用量为(123.71±23.14)mg、(12.36±2.11)g,均低于对照组[(163.28±24.65)mg、(16.59±2.43)g],差异均有统计学意义(P<0.05)。治疗后,两组血清Myo、CK-MB、cTnI、NT-proBNP水平均较治疗前下降,且联合组血清Myo、CK-MB、cTnI、NT-proBNP水平为(24.26±2.89)μg/L、(14.50±1.39)IU/L、(0.042±0.007)μg/L、(135.41±23.28)μg/L,较对照组[(32.77±3.15)μg/L、(17.58±2.00)IU/L、(0.055±0.008)μg/L、(155.34±28.77)μg/L]更低,差异均有统计学意义(P<0.05)。治疗后,两组血清miR-126、miR-92a水平均较治疗前下降,且联合组血清miR-126、miR-92a水平分别为87.36±25.41、0.23±0.07,较对照组(123.19±37.48、0.27±0.09)更低,差异均有统计学意义(P<0.05)。结论葛根素注射液联合血流灌注能够提高临床疗效,减少阿托品用量,降低患者血清miR-126和miR-92a表达水平,减轻有机磷中毒导致的心肌损伤。Objective To explore the clinical effect of puerarin injection combined with blood perfusion on myocardial injury and serum levels of miR-126 and miR-92a in patients with organophosphate pesticide poisoning.Methods One hundred and two patients with organophosphorus pesticide poisoning who were treated in our hospital from July 2020 to June 22 were selected as the study subjects.They were divided into combined group(n=56)and control group(n=46)according to the time of admission.The control group received blood perfusion therapy,and the combined group received puerarin injection on this basis.The treatment situation,serum myoglobin(Myo),creatine kinase-MB(CK-MB),troponin I(cTnI),N-terminal B-type natriuretic peptide precursor(N-proBNP)and serum miR-126 and miR-92a levels were compared between the two groups before and after treatment.Results The recovery time of cholinesterase activity to 80%,mechanical ventilation time,coma recovery time and hospital stay of combined group were(2.16±1.20)days,(18.02±2.19)hours,(12.39±2.07)hours,(6.35±0.88)days,which were shorter than those in the control group[(6.33±1.52)days,(21.56±3.26)hours,(15.36±2.44)hours,(8.62±1.59)days],and the dosage of atropine and pralidoxime iodide was(123.71±23.14)mg,(12.36±2.11)g,which was lower than that in combined group[(163.28±24.65)mg,(16.59±2.43)g],and the differences were statistically significant(P<0.05).After treatment,the serum levels of Myo,CK-MB,cTnI and NT-proBNP in the two groups were lower than those before treatment,and the serum levels of Myo,CK-MB,cTnI and NT-proBNP in the combination group were(24.26±2.89)μg/L,(14.50±1.39)IU/L,(0.042±0.007)μg/L,(135.41±23.28)μg/L,which were lower than those in the control group[(32.77±3.15)μg/L,(17.58±2.00)IU/L,(0.055±0.008)μg/L,(155.34±28.77)μg/L],the difference was statistically significant(P<0.05).After treatment,the serum levels of miR-126 and miR-92a in the two groups were lower than those before treatment,and the serum levels of miR-126 and miR-92a in the combination

关 键 词：有机磷 葛根素注射液 农药中毒 心肌损伤 血流灌注 

分 类 号：R595.4[医药卫生—内科学]