碘解磷定联合阿托品对急性有机磷农药中毒患者心肌损伤及微炎性指标的影响  

Effects of proxime iodide combined with atropine on myocardial injury and microinflammatory indexes in patients with acute organophosphorus pesticide poisoning

作　　者：卢安阳 古俊晓 王乙钧[1] 吕汝琦[1] LU Anyang;GU Junxiao;WANG Yijun;LYU Ruqi(Department of Emergency,Mianyang Central Hospital,Sichuan Province,Mianyang 621000,China)

机构地区：[1]四川省绵阳市中心医院急诊科,621000

出　　处：《临床合理用药杂志》2024年第26期4-7,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：四川省医院协会医院管理科研专项资金项目(YG2346)。

摘　　要：目的 观察碘解磷定联合阿托品对急性有机磷农药中毒患者心肌损伤及微炎性指标的影响。方法 选择2021年6月—2023年6月绵阳市中心医院收治的急性有机磷农药中毒患者80例,采用随机信封法分为观察组和对照组,每组40例。对照组接受阿托品治疗,观察组接受碘解磷定联合阿托品治疗。比较2组临床恢复指标,治疗前后心肌酶谱指标[天冬氨酸氨基转移酶(AST)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、乳酸脱氢酶(LDH)]、微炎性指标[C反应蛋白(CRP)、降钙素原(PCT)]及不良反应。结果 观察组N样、M样、CNS样症状消失时间、自主意识恢复时间、胆碱酯酶活力恢复时间及住院时间均短于对照组(P<0.01)。治疗后,2组AST、CK-MB、CK、LDH、CRP及PCT水平均低于治疗前,且观察组低于对照组(P<0.01)。观察组心动过速、药物中毒昏迷、反跳现象、视力模糊及尿潴留发生率低于对照组(P<0.05或P<0.01);2组中间综合征及迟发性神经病发生率比较差异无统计学意义(P>0.05)。结论 碘解磷定联合阿托品是急性有机磷农药中毒有效且安全的治疗方案,可促进患者胆碱酯酶活力恢复,缓解中毒症状,减轻心肌损伤及微炎性反应。Objective To observe the effects of proxime iodide combined with atropine on myocardial injury and microinflammatory indexes in patients with acute organophosphorus pesticide poisoning.Methods A total of 80 patients with acute organophosphorus pesticide poisoning treated in Mianyang Central Hospital from June 2021 to June 2023 were selected as the study objects and divided into observation group and control group by random envelope method,with 40 cases in each group.Control group was treated with atropine,observation group was treated with proxime iodide combined with atropine.Clinical recovery indexes,myocardial enzyme profile indexes(AST,CK-MB,CK,LDH),microinflammatory indexes(CRP,PCT) before and after treatment and adverse reactions were compared between the two groups.Results The disappearance time of N,M and CNS-like symptoms,the recovery time of autonomous consciousness,the recovery time of cholinesterase activity and the length of hospital stay in observation group were shorter than those in control group(P<0.01).After treatment,AST,CK-MB,CK,LDH,CRP and PCT levels in two groups were lower than before treatment,and observation group was lower than control group(P<0.01).The incidences of tachycardia,drug-induced coma,rebound phenomenon,blurred vision and urinary retention in observation group were lower than those in control group(P<0.05 or P<0.01).There was no significant difference in the incidence of intermediate syndrome and delayed neuropathy between two groups(P>0.05).Conclusion Proxime iodide combined with atropine is an effective and safe treatment for acute organophosphorus pesticide poisoning,which can promote the recovery of cholinesterase activity,relieve the symptoms of poisoning,and alleviate myocardial injury and micro-inflammatory reaction.

关 键 词：急性有机磷农药中毒 碘解磷定 阿托品 心肌损伤 微炎性指标 

分 类 号：R595.4[医药卫生—内科学]