摘要
目的：探讨丹参注射液对急性有机磷农药中毒患者心肌保护作用、血液流变学及预后效果的影响。方法选取2012年1月至2013年12月本院急诊科有机磷中毒患者68例，按随机数字表将患者分为两组各34例，对照组给予阿托品5～10 mg解毒，凯西莱0.2 g/（次？d）保肝治疗，先锋必0.2 g/（次？d）预防感染。观察组在对照组基础上静脉滴注丹参注射液30 ml，1次/d，两组均治疗7 d为1个疗程。治疗前后观察两组心肌酶谱[谷草转氨酶（AST）、肌酸磷酸激酶（CK）、肌酸磷酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、羟丁酸脱氢酶（HBDH）]及血液流变学指标[红细胞沉降率（ESR）、纤维蛋白原（FIB）、全血黏度低切（LBV）、全血黏度高切（HBV）]变化。结果治疗后观察组抢救成功率为94.12%（32/34）、对照组抢救成功率为79.41%（27/34），两组抢救成功率比较，差异有统计学意义（χ2＝5.123，P＜0.01）。观察组治疗后2 d心肌酶谱（AST、CK、CK-MB、LDH、HBDH）各指标[分别为（58.6±22.7）U/L、（412.6±156.9）U/L、（78.6±35.2）U/L、（489.3±112.3）U/L、（412.8±259.6）U/L；]及血液流变学（ESR、FIB、LBV、HBV）各指标[分别为（14.36±4.19）mm/h、（259.3±23.1）g/L、（7.2±1.1）mPa？s、（4.1±0.8）mPa？s]显著低于同组治疗前[心肌酶谱分别为（131.3±32.5） U/L、（1324.5±345.2）U/L、（187.5±72.2）U/L、（914.5±312.2）U/L、（812.3±312.2）U/L；血液流变学各指标分别为（23.3±3.5）mm/h、（389.6±34.2）g/L、（10.4±1.3）mPa？s、（6.3±1.2）mPa？s]。对照组治疗后5 d心肌酶谱各指标[分别为（85.3±22.8）U/L、（486.3±78.9）U/L、（67.8±11.2）U/L、（542.3±78.6）U/L、（225.9±112.4）U/L]及血液流变学各指标[分别为（17.7±4.6）mm/h、（289.4±32.5）g/L、（8.9±1.2）mPa？s、（5.6±1.3）mPa？s]明显低于同组治疗前[心肌酶谱各指标分别为（128.3±29.3）U/L、（1298.6±329.4）U/L、（182.6±70.6）U/L、（902.3±286.3）U/L、（803.6±293.6）U/L；血液流变学各指标分别为（23.9±3.5）mm/h、（382.6±32.5）g/L、（10.3±1.1）mPa？s、（6.2±1.1）mPa？s，P＜0.05]。结论丹参注射液可有效改善急性有机磷农药中毒患者血液流变学相关指标，减轻有机磷农药对心肌的损害。
Objective To investigate the effects of hemodynamic,prognostic effect and myocardial protection of Salvia injection on patients with acute organophosphorus pesticide poisoning. Methods 68 cases of patients with acute organophosphate were divided into observation group（n=34）and control group（n=34） from January 2012 to December 2013.The control group were given with atropine detoxification （dose：5-10mg）, Tiopronin （0.2 g/d, 1 times/d） liver treatment, Pioneer will（2 g/second,1/d）.The observed group received the foundation treatment and Salvia injection（30ml, 1/d）, 7d course of treatment. The myocardial enzymes and hemodynamic parameters of two groups were observed before and after treatment. Results The survival rate and died rate of observation group were 94.12%（32 cases ）, 5.88%（2 cases ）. The survival rate and died rate of control group were 79.41%（27cases ）and 20.59%（7cases）. The survival rate and died rate of two groups were significant difference （χ2=5.123, P〈0.05）. The myocardial enzymes （AST, CK, CK-MB, LDH, HBDH） of observation groupafter 2d each index[were（58.6±22.7）U/L, （412.6±156.9）U/L, （78.6±＆amp;nbsp;35.2）U/L, （489.3 ± 112.3）U/L, （412.8 ± 259.6）U/L] and blood rheology （ESR, FIB, LBV, HBV）each index[were（14.36±4.19） mm/h before , （259.3±23.14）g/L, （7.17±1.12）mPa？s, （4.12±0.81）mPa？s]were lower than in the same group therapy [myocardial enzymes indexes were （131.3±32.5）U/L, （1324.5± 345.2）U/L, （187.5 ± 72.2）U/L, （914.5 ± 312.2）U/L, （812.3 ± 312.2）U/L; hemorheology indexes were （23.29±3.49）mm/h, （389.57±34.24） g/L, （10.4±1.3）mPa？s, （6.3±1.2）mPa？s]. 5 d after treatment control group myocardial enzymes（AST, CK, CK-MB, LDH, HBDH）each index[were（85.3±22.8）U/L, （486.3± 78.9）U/L, （67.8±11.2）U/L, （542.3±78.6）U/L, （225.9±112.4）U/L]and hemorheology indexes[were（17.7± 4.6）mm/h, （289.4±32.5）g/L, （8.9±1.2）mPa？s, （5.6±1.3）mPa？s] was significantly lower than in the same group before treatment[myocardial enzymes indexes were（128.3±29.3）U/L, （1298.6±329.4）U/L, （182.6± 70.6）U/L, （902.3±286.3）U/L, （803.6±293.6）U/L;hemorheology indexes were （23.9±3.5）mm/h, （382.6± 32.5）g/L, （10.3±1.1）mPa？s, （6.2±1.1）mPa？s, P〈0.05]. Conclusion Salvia injection can effectively improve the hemodynamic indicators of acute organophosphorus pesticide poisoning patients , reduce myocardial damage, promote patient prognosis.
出处
《国际中医中药杂志》
2014年第9期798-801,共4页
International Journal of Traditional Chinese Medicine
关键词
丹参注射液
急性有机磷
心肌
血液流变学
Salvia injection
Acute organophosphorus
Myocardium
Hemodynamic
