不同剂量阿托品对急性有机磷农药中毒患者短期预后的影响  

Effects of Different Doses of Atropine on Short-term Prognosis of Patients with Acute Organophosphorus Pesticide Poisoning

作　　者：晏万述 常裕鑫 姚魏魏 杜国威[2] YAN Wanshu;CHANG Yuxin;YAO Weiwei(The Affiliated Qingdao Central Hospital of Qingdao University,Qingdao Shandong 266042)

机构地区：[1]青岛大学附属青岛市中心医院暨青岛大学第二临床医学院急救中心,山东青岛266042 [2]青岛大学附属青岛市中心医院暨青岛大学第二临床医学院肿瘤科,山东青岛266042

出　　处：《医学临床研究》2023年第10期1496-1499,共4页Journal of Clinical Research

摘　　要：【目的】探讨不同剂量阿托品对急性有机磷农药中毒(AOPP)患者短期预后的影响。【方法】120例AOPP患者,随机分为大剂量组和小剂量组,每组60例。大剂量组给予阿托品首次剂量5~10 mg,根据患者反应10~30 min静脉推注2~5 mg,直至患者阿托品化;小剂量组给予阿托品首次剂量2~5 mg,根据患者反应10~30 min静脉推注1~2 mg,直至患者阿托品化。比较两组临床疗效、治疗前后血细胞参数[白细胞计数(WBC)、中性粒细胞计数(NC)、淋巴细胞计数(LC)以及中性粒细胞/淋巴细胞比值(NLR)]变化、治疗前后C反应蛋白(CRP)、嗜酸性粒细胞(EOS)变化、乙酰胆碱酯酶(AchE)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平以及用药安全性。【结果】大剂量组治愈率为85.00%(51/60),显著优于小剂量组的68.33%(41/60)(P<0.05)。大剂量组阿托品用量显著高于小剂量组(P<0.05),两组机械通气、ICU留住时间和住院时间比较,差异无统计学意义(P>0.05)。治疗后,两组患者WBC、NC以及NLR均低于治疗前,LC高于治疗前(P<0.05);CRP、EOS低于治疗前(P<0.05);AchE、SOD高于治疗前,MDA低于治疗前(P<0.05);且大剂量组上述指标均优于小剂量组(P<0.05)。大剂量组不良事件发生率略高于小剂量组,但两组比较,差异无统计学意义(P>0.05)。【结论】大剂量阿托品治疗AOPP效果明显优于小剂量,可明显改善患者血细胞参数,调节炎症因子与氧化应激水平且用药安全性良好。【Objective】To investigate the effects of different doses of atropine on short-term prognosis of patients with acute organophosphorus pesticide poisoning(AOPP).【Methods】A total of 120 patients with AOPP were randomly divided into high-dose group and low-dose group,with 60 patients in each group.The high-dose group received an initial dose of atropine of 5-10 mg,and intravenous injection of 2-5 mg every 10-30 min according to the patient's response,until the patient was atropinized.The low-dose group received an initial dose of atropine of 2-5 mg,and intravenous injection of 1-2 mg every 10-30 min according to the patient's response,until the patient was atropinized.The clinical efficacy,changes in blood cell parameters[white blood cell count(WBC),neutrophil count(NC),lymphocyte count(LC),and neutrophil/lymphocyte ratio(NLR)],changes in C-reactive protein(CRP),eosinophils(EOS),acetylcholinesterase(AchE),superoxide dismutase(SOD),malondialdehyde(MDA)levels,and drug safety were compared between the two groups.【Results】The cure rate in the high-dose group was 85.00%(51/60),which was significantly better than 68.33%(41/60)in the low-dose group(P<0.05).The amount of atropine used in the high-dose group was significantly higher than that in the low-dose group(P<0.05),but there was no significant difference in mechanical ventilation,ICU stay,and hospital stay between the two groups(P>0.05).After treatment,WBC,NC,and NLR in both groups were lower than before treatment,while LC was higher than before treatment(P<0.05);CRP and EOS were lower than before treatment(P<0.05);AchE and SOD were higher than before treatment,while MDA was lower than before treatment(P<0.05);and the above indexes in the high-dose group were better than those in the low-dose group(P<0.05).The incidence of adverse events in the high-dose group was slightly higher than that in the low-dose group,but there was no significant difference between the two groups(P>0.05).【Conclusion】High-dose atropine treatment for AOPP is significantly better

关 键 词：阿托品/投药和剂量 杀虫药/中毒 有机磷化合物/中毒 急性病 预后 

分 类 号：R595.4[医药卫生—内科学]