摘要
目的:探讨不同剂量氯解磷定联合血液灌流治疗对急性有机磷农药中毒患者的治疗效果,以及对血清超敏心肌肌钙蛋白Ⅰ(hs-cTnⅠ)和可溶性致癌抑制因子2(sST2)水平的影响。方法:选取2019年3月~2021年11月期间于本院就诊的86例急性有机磷农药中毒患者作为研究对象,按照随机数字表法分为观察组和对照组,每组43例。对照组给予常规剂量氯解磷定联合血液灌流治疗,观察组给予突击剂量氯解磷定联合血液灌流治疗,比较两组临床恢复情况、血浆胆碱酯酶(ChE)、炎症因子[C反应蛋白(CRP)、降钙素原(PCT)]、hs-cTnⅠ、sST2水平及不良反应发生情况。结果:治疗后,观察组清醒时间、ChE恢复正常时间均早于对照组(P<0.05),住院时间短于对照组(P<0.05);两组CRP、PCT水平均降低(P<0.05),且观察组各指标水平均低于对照组(P<0.05);两组hs-cTnⅠ和sST2水平均降低(P<0.05),且观察组各指标水平均低于对照组(P<0.05);两组患者不良反应发生情况比较无统计学差异(P>0.05)。治疗前,两组ChE水平比较无统计学差异(P>0.05);治疗24h、48h后,观察组ChE水平高于对照组(P<0.05)。结论:不同剂量氯解磷定联合血液灌流治疗对急性有机磷农药中毒患者的治疗效果不同,突击剂量氯解磷定联合血液灌流治疗可缩短病程,加快ChE恢复,减轻炎症反应,降低hs-cTnⅠ和sST2水平,且治疗期间不良反应发生率较低。
Objective:To investigate the efficacy of different doses of pralidoxime chloride combined with hemoperfusion in patients with acute organophosphorus pesticide poisoning,as well as effects on serum levels of high-sensitivity cardiac troponinⅠ(hs-cTnⅠ)and soluble suppression of tumorigenicity 2(sST2).Methods:Eighty-six patients with acute organophosphorus pesticide poisoning who were admitted to the hospital between March 2019 and November 2021 were selected as the study subjects.The patients were randomly divided into the observation group and the control group using the random number table,with 43 patients in each group.The control group was treated with a conventional dose of pralidoxime chloride combined with hemoperfusion,while the observation group was treated with a loading dose of pralidoxime chloride combined with hemoperfusion.The clinical recovery,plasma levels of cholin esterase(ChE),inflammatory factors[C reactive protein(CRP),procalcitonin(PCT)],hs-cTnⅠ,sST2 and the occurrence of adverse reactions were compared between the two groups.Results:After treatment,the observation group had a shorter time to consciousness and ChE recovery(P<0.05),as well as a shorter duration of hospitalization than the control group(P<0.05).A significant reduction of the CRP and PCT levels was observed in both groups(P<0.05),and the levels of the two outcome measures were lower in the observation group than those in the control group(P<0.05).A remarked reduction of the hs-cTnⅠand sST2 levels was noted in both groups(P<0.05),and the levels of the two outcome measures were lower in the observation group than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).The two groups were not observed with a statistically significant difference in the ChE level before treatment(P>0.05).However,the observation group had a higher ChE level at 24h and 48h after treatment than the control group(P<0.05).Conclusion:Different doses of pralidoxime chloride combined with hemoperfusion produced a different therapeutic effect in the patients with acute organophosphorus pesticide poisoning.The loading dose of pralidoxime chloride combined with hemoperfusion shortened the course of disease,promoted the recovery of ChE,and reduced inflammatory reactions and the levels of hscTnⅠand sST2 effectively,with a low incidence of adverse reactions during treatment.
作者
单智勇
黄勇进
杨晗
SHAN Zhi-yong;HUANG Yong-jin;YANG Han(Emergency Department,The First People's Hospital of Shangqiu,Shangqiu 476000,China)
出处
《中国合理用药探索》
CAS
2023年第7期106-111,共6页
Chinese Journal of Rational Drug Use
基金
河南省高等学校重点科研项目(20C470026)。
关键词
不同剂量
氯解磷定
血液灌流
有机磷农药中毒
超敏心肌肌钙蛋白
可溶性致癌抑制因子2
different dose
pralidoxime chloride
hemoperfusion
organophosphorus pesticide poisoning
high-sensitivity cardiac troponin
soluble suppression of tumorigenicity 2
