血必净注射液对有机磷农药中毒患者炎症反应及心功能的影响
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摘要
目的探讨血必净注射液对有机磷农药中毒患者炎症反应及心功能的影响。方法选取106例重度急性有机磷农药中度患者进行研究,按随机数字表法将其分为观察组与对照组,对照组患者采用常规治疗,观察组在此基础上联合血必净注射液治疗。比较两组患者治疗前后胆碱酯酶(CHE)活性恢复60%时间、住院时间、治愈率、反跳率、炎性因子水平及心功能指标。结果观察组CHE活性恢复60%时间及住院时间较对照组缩短,反跳率低于对照组,差异均有统计学意义(P <0. 05)。观察组治愈率略高于对照组,但差异无统计学意义(P> 0. 05)。治疗后,两组患者炎性因子水平均较治疗前降低(P <0. 05),观察组CRP、TNF-α与IL-6均低于对照组,差异有统计学意义(P <0. 05)。治疗后,两组心功能指标均较治疗前改善,观察组LVEF高于对照组,LVIDd及BNP均低于对照组,差异有统计学意义(P <0. 05)。观察组共发生并发症10例(18. 87%),对照组共发生并发症21例(39. 62%),两组并发症发生率比较差异有统计学意义(P <0. 05)。结论血必净注射液可有效控制重度急性有机磷农药中毒患者炎症反应,促进心功能的改善,疗效良好。
Objective To investigate the influence of Xuebijing injection on inflammatory reaction and cardiac function in patients with organophosphorus intoxication. Methods Totally 106 cases of patients with organophosphorus intoxication were chosen as experimental subjects,and were randomly divided into observation group and control group. Control group was treated with routine treatment,and observation group was treated with Xuebijing injection on the basis of conventional treatment. The cholinesterase( CHE) active 60% time,hospitalization time,cure rate,rebound rate,levels of inflammatory factors and cardiac function were compared between the two groups before and after treatment. Results The CHE active 60% time and hospitalization time of observation group were shorter than those of control group,and the rebound rate was lower than that of control group,the difference being statistically significant( P < 0. 05). The cure rate of observation group was slightly higher than that of control group,but the difference being not statistically significant( P > 0. 05). After treatment,and the levels of inflammatory factors in the two groups were all lower than those before treatment( P < 0. 05),and the CRP,TNF-α and IL-6 in observation group were all lower than those in control group,the difference being statistically significant( P < 0. 05). After treatment,the cardiac function indexes of the two groups were all improved compared with those before treatment,and the LVEF in observation group was higher than that in control group,while the LVIDd and BNP were all lower than those in control group,the difference being statistically significant( P < 0. 05). There were 10 complications( 18. 87%) in observation group and21 complications( 39. 62%) in control group,and there was significant difference in the incidence of complications between the two groups( P < 0. 05). Conclusion Xuebijing injection can effectively control the inflammatory response of patients with severe acute organophosphorus intoxication and promote the improvement of cardiac function,and the curative effect is good.
Objective To investigate the influence of Xuebijing injection on inflammatory reaction and cardiac function in patients with organophosphorus intoxication. Methods Totally 106 cases of patients with organophosphorus intoxication were chosen as experimental subjects,and were randomly divided into observation group and control group. Control group was treated with routine treatment,and observation group was treated with Xuebijing injection on the basis of conventional treatment. The cholinesterase( CHE) active 60% time,hospitalization time,cure rate,rebound rate,levels of inflammatory factors and cardiac function were compared between the two groups before and after treatment. Results The CHE active 60% time and hospitalization time of observation group were shorter than those of control group,and the rebound rate was lower than that of control group,the difference being statistically significant( P < 0. 05). The cure rate of observation group was slightly higher than that of control group,but the difference being not statistically significant( P > 0. 05). After treatment,and the levels of inflammatory factors in the two groups were all lower than those before treatment( P < 0. 05),and the CRP,TNF-α and IL-6 in observation group were all lower than those in control group,the difference being statistically significant( P < 0. 05). After treatment,the cardiac function indexes of the two groups were all improved compared with those before treatment,and the LVEF in observation group was higher than that in control group,while the LVIDd and BNP were all lower than those in control group,the difference being statistically significant( P < 0. 05). There were 10 complications( 18. 87%) in observation group and21 complications( 39. 62%) in control group,and there was significant difference in the incidence of complications between the two groups( P < 0. 05). Conclusion Xuebijing injection can effectively control the inflammatory response of patients with severe acute organophosphorus intoxication and promote the improvement of cardiac function,and the curative effect is good.
引文
[1]涂学平,袁鹰,向鑫,等.阿托品与长托宁联合治疗重度急性有机磷农药中毒的疗效[J].临床急诊杂志,2016,18(12):932-934.
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[8]张天增,任佳,张合风.乌司他丁在重度有机磷中毒全身反应综合征中的应用[J].中原医刊,2005,32(16):34-35.
[9]宾文凯,沈严严,黄淑田.有机磷农药中毒对心功能影响的研究进展[J].中华内科杂志,2010,49(3):273-274.
[10]刘贞,杨圣强,杨文宝,等.序贯性血液净化对急性有机磷农药中毒患者心功能的影响[J].中国医师进修杂志,2015,38(7):482-485.
[11]张秋峰.血必净注射液联合氯解磷定注射液治疗有机磷农药中毒的临床研究[J].现代药物与临床,2017,32(6):1057-1060.
[12]张淑芬.血必净注射液的临床应用概况[J].现代中西医结合杂志,2008,17(15):2418-2419
[2]谢勇.乌司他丁对有机磷农药中毒患者炎症反应及治疗效果的影响[J].中国现代药物应用,2015,9(9):163-164.
[3]杨圣强,刘贞,王波,等.血液灌流联合血液滤过对急性有机磷农药中毒患者的心脏保护作用研究[J].中华临床医师杂志:电子版,2014,(18):3283-3287.
[4]朱明锦,张庚,胡马洪,等.化瘀解毒之血必净注射液治疗重症肺炎疗效的系统评价[J].中国循证医学杂志,2014,19(4):462-468.
[5]张威,黄昌保,江云,等.急性重度有机磷农药中毒并发症的发生与毒物种类之间的相关性分析[J].中国急救复苏与灾害医学杂志,2017,12(4):309-311.
[6]向明权,梁平华,梁军,等.长托宁和阿托品治疗重度有机磷农药中毒76例临床观察[J].海南医学院学报,2014,20(8):1084-1085,1088.
[7]王飞.长托宁对急性有机磷农药中毒患者血气分析、心肌酶谱及炎症因子的影响[J].中国急救复苏与灾害医学杂志,2017,12(10):1007-1010.
[8]张天增,任佳,张合风.乌司他丁在重度有机磷中毒全身反应综合征中的应用[J].中原医刊,2005,32(16):34-35.
[9]宾文凯,沈严严,黄淑田.有机磷农药中毒对心功能影响的研究进展[J].中华内科杂志,2010,49(3):273-274.
[10]刘贞,杨圣强,杨文宝,等.序贯性血液净化对急性有机磷农药中毒患者心功能的影响[J].中国医师进修杂志,2015,38(7):482-485.
[11]张秋峰.血必净注射液联合氯解磷定注射液治疗有机磷农药中毒的临床研究[J].现代药物与临床,2017,32(6):1057-1060.
[12]张淑芬.血必净注射液的临床应用概况[J].现代中西医结合杂志,2008,17(15):2418-2419