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论著:还原型谷胱甘肽治疗急性有机磷中毒引起的心肌损害
Glutathione Used to Treat Myocardial Damage Caused by Acute Organophosphorus Pesticide Poisoning
全彩娟 周明浩 张菊红 吉春风
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作者单位:复旦大学附属中山医院青浦分院急诊科
中文关键字:急性有机磷农药中毒;心肌损害;还原型谷胱甘肽
英文关键字:Acute organophosphorus pesticide poisoning;Myocardial damage;Glutathione
中文摘要:目的:探讨还原型谷胱甘肽(GSH)治疗急性有机磷中毒(AOPP)引起的心肌损害的效果。方法:急性AOPP患者60例,随机分为2组,治疗组30例,对照组30例,2组患者均常规给予洗胃、补液、阿托品、长托宁、解磷定等治疗,治疗组在此基础上给予GSH 2 400 mg/d。检测入院后第1小时、第24小时、第72小时、第168小时的血清肌钙蛋白(cardiac troponin T, cTnT)、天门冬氨酸氨基转移酶(aspartate aminotransferase, AST)、丙氨酸氨基转移酶(alanine aminotransferase, ALT)、磷酸肌酸激酶(creatine kinase, CK)、磷酸肌酸激酶同功酶(creatine kinase MB, CK MB)、乳酸脱氢酶(lactate dehydrogenase, LDH)及胆碱酯酶(cholinesterase, CHE)含量,同时进行心电图检查。比较2组患者在治疗前后cTnT、AST、ALT、CK、CK MB、LDH及CHE含量的变化和心电图变化。结果:急性AOPP患者cTnT、AST、ALT、CK MB及LDH均有不同程度升高。治疗组心肌酶恢复情况优于对照组。结论:GSH能减轻急性AOPP引起的心肌损害。
英文摘要:Objective:To investigate the effect of glutathione on myocardial damage caused by acute organophosphorus pesticide poisoning. Methods: A total of 60 patients with acute organophosphorus pesticide poisoning admitted to our hospital were randomly divided into two groups, the treatment group(n=30) and the control group (n=30). Gastric lavage, fluid replacement, atropine, PHC, pralidoxime were routinely given in both groups, while the treatment group was additionally given glutathione 2400 mg/d. The levels of cardiac troponin T (cTnT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), creatine kinase MB (CK MB), lactate dehydrogenase (LDH), cholinesterase (CHE) and electrocardiogram in both groups were examined at the 1st hour, 24th hours, 72th hours and 7th days after admission. Results: The levels of cTnT, AST, ALT, CK MB and LDH increased in the blood of patients with acute organophosphorus pesticide poisoning. Glutathione could significantly decrease those index in the treatment group. Conclusions: Glutathione have a significant protective effect to myocardial damage caused by acute organophosphorus poisoning.
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