长托宁联合血液灌流治疗对重症急性有机磷农药中毒患者心肌酶谱及氧化应激水平的影响研究  

Effect of Changtuoning combined with hemoperfusion on myocardial enzymes and oxidative stress level in patients with severe acute organophosphorus poisoning

作　　者：刘贵超 LIU Gui-chao(Intensive Care Unit,Southwestern Lu Hospital,Liaocheng 252309,China)

机构地区：[1]聊城市鲁西南医院重症医学科,252309

出　　处：《中国现代药物应用》2023年第10期14-18,共5页Chinese Journal of Modern Drug Application

摘　　要：目的 探讨盐酸戊乙奎醚注射液(商品名:长托宁)联合血液灌流治疗对重症急性有机磷农药中毒(AOPP)患者心肌酶谱及氧化应激水平的影响。方法 96例重症AOPP患者,依照计算机随机数字表法分为对照组与实验组,每组48例。对照组患者给予长托宁联合血必净治疗,实验组患者在对照组基础上给予血液灌流。比较两组抢救情况(昏迷时间、胆碱酯酶恢复时间、住院时间),治疗前后心肌酶谱指标[胆碱酯酶活性、肌酸激酶(CK)]水平,治疗前后氧化应激指标[超氧化物歧化酶(SOD)、乳酸脱氢酶(LDH)]水平,治疗前后炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]水平,治疗前后肾功能指标(尿素氮、肌酐、尿酸)水平。结果 实验组患者的昏迷时间、胆碱酯酶恢复时间、住院时间分别为(13.10±1.06)h、(6.89±1.52)d、(9.32±2.45)d,均明显短于对照组的(15.48±1.36)h、(11.02±1.69)d、(17.38±3.56)d,差异具有统计学意义(P<0.05)。治疗前,两组患者的胆碱酯酶活性、CK水平比较差异无统计学意义(P>0.05);治疗后72 h,实验组患者的胆碱酯酶活性(560.36±30.15)U/L明显高于对照组的(480.70±20.63)U/L,CK(436.20±6.58)U/L明显低于对照组的(482.15±7.46)U/L,差异具有统计学意义(P<0.05)。治疗前,两组患者的SOD、LDH水平比较差异无统计学意义(P>0.05);治疗后72 h,实验组SOD(468.26±11.20)U/ml明显高于对照组的(425.36±9.05)U/ml,LDH(2815.36±24.75)U/L明显低于对照组的(3615.28±27.60)U/L,差异具有统计学意义(P<0.05)。治疗前,两组患者的TNF-α、IL-6、IL-8水平比较差异无统计学意义(P>0.05);治疗后72 h,实验组患者的TNF-α、IL-6、IL-8分别为(88.36±13.26)、(8.30±1.63)、(72.30±12.26)pg/ml,均明显低于对照组的(128.69±14.52)、(11.52±1.89)、(94.36±14.80)pg/ml,差异具有统计学意义(P<0.05)。治疗前,两组患者的尿素氮、肌酐、尿酸水平比较差异无统计学意义Objective To discuss the effect of penehyclidine hydrochloride injection(trade name:Changtuoning)combined with hemoperfusion on myocardial enzymes and oxidative stress level in patients with severe acute organophosphorus poisoning(AOPP).Methods A total of 96 patients with severe AOPP were divided into control group and experimental group according to computer random numerical table,with 48 cases in each group.The control group was treated with Changtuoning and hemoperfusion,and the experimental group was treated with hemoperfusion on the basis of the control group.Both groups were compared in terms of rescue conditions(duration of coma,recovery time of cholinesterase,length of hospital stay),myocardial enzyme indexes[cholinesterase activity,creatine kinase(CK)]levels before and after treatment,oxidative stress indexes[superoxide dismutase(SOD),lactate dehydrogenase(LDH)]levels before and after treatment,inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)]levels,renal function indicators(urea nitrogen,creatinine,uric acid)before and after treatment.Results The duration of coma,recovery time of cholinesterase and length of hospital stay of the experimental group were(13.10±1.06)h,(6.89±1.52)d and(9.32±2.45)d,which were significantly shorter than those of(15.48±1.36)h,(11.02±1.69)d and(17.38±3.56)d of the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in cholinesterase activity and CK level between the two groups(P>0.05).72 h after treatment,the cholinesterase activity of(560.36±30.15)U/L in the experimental group was significantly higher than that of(480.70±20.63)U/L in the control group;CK of(436.20±6.58)U/L in the experimental group was significantly lower than that of(482.15±7.46)U/L in the control group;the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in SOD and LDH levels between the two groups(P

关 键 词：重症急性有机磷农药中毒 盐酸戊乙奎醚注射液 血液灌流 心肌酶谱 氧化应激 

分 类 号：R595.4[医药卫生—内科学]