摘要
目的探讨丁苯酞联合神经节苷脂对急性重度一氧化碳中毒患者乳酸清除率及免疫T细胞的影响。方法选自第三军医大学第一附属医院2014年6月至2016年6月期间收治的急性重度一氧化碳中毒患者94例,依据随机数字表法分为观察组47例与对照组47例。对照组给予神经节苷脂治疗,观察组在对照组基础上结合丁苯酞治疗。两组疗程均为4周。比较两组治疗疗效、24 h血乳酸清除率、一氧化碳中毒后迟发性脑病(DEACMP)发生率,治疗前后GCS评分和免疫功能指标变化。组间和组内计量资料两两比较采用t检验,等级计数资料的比较采用卡方检验。结果观察组治疗总有效率(93.62﹪)高于对照组(74.47﹪)(c^2=6.425,P<0.05);两组患者治疗后GCS评分增加(P<0.05);观察组患者治疗后GCS评分(14.23±1.69)分高于对照组(11.35±1.45)分,差异具有统计学意义(t=8.867,P<0.05);观察组24 h血乳酸清除率(65.98±4.52)﹪高于对照组(41.39±3.67)﹪,差异具有统计学意义(t=28.954,P<0.05);两组治疗后CD3^+、CD4^+、CD4(+CD8^+)增加,而CD8^+降低(P<0.05);观察组治疗后CD3^+(62.30±4.19)﹪、CD4^+(62.30±4.19)﹪、CD4^+(CD8^+)(1.64±0.31)﹪高于对照组CD3^+(57.12±3.76)﹪、CD4^+(38.91±3.10)﹪、CD4^+(CD8^+)(1.34±0.24)﹪,而CD8^+(25.78±2.18)﹪低于对照组(29.08±2.31)﹪,差异具有统计学意义(t=6.308、4.755、5.246、7.123,P<0.05);观察组DEACMP发生率(4.26﹪)低于对照组(23.40﹪),差异具有统计学意义(c^2=7.231,P<0.05)。结论丁苯酞联合神经节苷脂对急性重度一氧化碳中毒患者疗效明显,可提高乳酸清除率,改善患者免疫功能,具有重要研究意义。
Objective To investigate the effect of butylphthalide combined with ganglioside on lactic acid clearance rate and T cells in patients with severe acute carbon monoxide poisoning. Methods Ninty four patients with acute severe carbon monoxide poisoning were enrolled from our hospital from June 2014 to June 2016 and randomized into the experimental group （n = 47） and the control group （n = 47） using a random number table. The control group was given ganglioside and the experimental group ganglioside and butylphthalide for 4 weeks. Blood lactate clearance rate, delayed encephalopathy after acute carbon monoxide poisoning （DEACMP） incidence, GCS score and immune function indexes were compared between the two groups. Data analysis was performed using SPSS 16.0 statistical software. Results The efficiency of the experimental group （93.62 % ） was higher than that of the control group （74.47 % ） （Х^2= 6.425,P 〈 0.05 ） ; GCS scores of both groups increased （P 〈 0.05 ） ; patients in the experimental group had higher GCS score after treatment （ 14.23 ± 1.69） than the control group （ 11.35 ±1.45, t = 8.867, P 〈 0.05 ） ; the experimental group also had higher 24 h blood lactate clearance rate （ 65.98±4.52 ） % than the control group （41.39 % ±3.67 %, P 〈 0.05 ） ; In both groups the percentages of CD3^＋ and CD4^＋ cells and CD4^＋ （CD8^＋） ratio increased, but the percentage ofCD8^＋ cells decreased （P 〈 0.05 ） after treatment; the experimental group had higher percentages of CD3^＋ cells （62.30±4.19） % and CD4^＋ cells （62.30 ± 4.19） %, and higher CD4^＋ （CD8^＋） ration （ 1.64± 0.31 ） than the control group [CD3^＋ cell： （57.12±3.76）%, CD4^＋ cells： （38.91±3.10）%, CD4^＋（CD8^＋）ratio： （1.34±0.24）, but lower CD8^＋ cell percentage （25.78 % ± 2.18 % vs 29.08 % ±2.31%, t = 6.308, 4.755, 5.246, and 7.123 respectively, P 〈 0.05]; the experimental group had lower incidence of DEACMP （4.26 % ） than the control group （23.40%） （Х^2= 7.231, P 〈 0.05）. Conclusion Butylphthalide combined with ganglioside is more effective than ganglioside alone for the treatment of acute severe carbon monoxide poisoning, with improved lactate clearance rate and immune function.
出处
《中华细胞与干细胞杂志（电子版）》
2017年第2期77-80,共4页
Chinese Journal of Cell and Stem Cell（Electronic Edition）
关键词
苯丙酮类
神经节苷脂类
一氧化碳中毒
乳酸
代谢清除率
T淋巴细胞
Propiophenones
Gangliosides
Carbon monoxide poisoning
Lactic acid
Metabolic clearance rate
T-Lymphocytes
