依地酸二钠钙联合微量元素合剂治疗铅中毒108例临床分析

目的探讨依地酸二钠钙(CaNa2EDTA)联合微量元素合剂及葡萄糖酸钙对慢性铅中毒的治疗效果。方法使用小剂量依地酸二钠钙(1.0g·d-1)、葡萄糖酸钙和微量元素合剂(含硫酸锌、硫酸铜、高锰酸钾、枸橼酸铁铵),并辅以支持疗法治疗铅中毒108例。结果所有患者均在1~3个疗程(每疗程6~7d)内治愈,无1例络合综合征发生。结论小剂量依地酸二钠钙、葡萄糖酸钙及微量元素合剂联合应用,可尽早缓解症状,缩短病程,避免副作用。     

对二甲氨基酚,依地酸二钴和亚硝酸钠对犬心脏血流动力学的影响

本文观察了DMAP,Co_2 EDTA和NaNO_2对犬心脏血流动力学的影响。iv DMAP 3.2mg/kg后LVP及其±dP/dtmax短暂轻度增加,CI,MAP,TPVR,LVWI和HR在30 min内基本稳定,至60 min时CI,LVWI和-dp/dtmax下降。iv Co_2EDTA 15mg/kg或NaNO_2 20 mg/kg后10 min MAP,CI,LVWI,LVP,±dP/dtmax及TPVR(Co_2EDTA组除外)降低最明显,60 min时NaNO_2组CI,MAP,TPVR,LVP和LVWI及Co+2EDTA组CI和LVWI仍然下降。Co_2EDTA组TPVR 1min时下降,5 min见恢复,60min上升。表明(1)DMAP能维持血压和外周血管张力平稳,使心脏舒缩性能短暂轻度增强;(2)Co_2EDTA初期降压系由其扩张血管和抑制心功能所致,后期降压主要由后者引起;(3)NaNO_2降压作用系通过扩张外周血管和抑制心功能所致。     

丹参辅助治疗职业性铅中毒的临床观察

[目的]观察丹参注射液辅助治疗铅中毒的疗效。[方法]用病历回顾方法对5年中使用依地酸钙钠药物合用丹参注射液治疗45例(观察组)和单纯依地酸钙钠药物治疗铅中毒47例(对照组)进行比较分析。[结果]观察组与对照组比较,治疗1～2个疗程后失眠、健忘、头痛、腹痛、便秘、纳差、乏力、体重减轻症状观察组较对照组改善明显(P﹤0.05);治疗3个疗程后血尿铅正常人数显著增多(P﹤0.01),观察组治疗效果佳,治愈快。[结论]依地酸钙钠药物合用丹参注射液治疗铅中毒比单用依地酸钙钠药物疗效显著。     

Development and validation of simple titrimetric method for the determination of magnesium content in esomeprazole magnesium

A simple and inexpensive titrimetric method for the determination of magnesium ion in esomeprazole magnesium raw material was developed and validated according to International Conference on Harmonization guidelines and the United States Pharmacopoeia. The method depends on complex formation between EDTA and magnesium ion. The method was proven to be valid, equivalent and useful as an alternative method to the current pharmacopeial methods that are based on atomic absorption spectrometry.     

囗服二巯丁二酸、静滴依地酸钙钠对铅中毒的驱铅效果比较

目的比较囗服二巯丁二酸和静脉滴注(静滴)依地酸钙钠对铅中毒的驱铅效果。方法50例铅中毒患儿,采用随机抽签法分为对照组与研究组,每组25例。对照组患儿静滴依地酸钙钠治疗,研究组患儿囗服二巯丁二酸治疗。对比两组临床疗效、不良反应发生情况、生活质量评分。结果研究组临床总有效率为96.00%,与对照组的88.00%对比差异无统计学意义(P>0.05)。研究组不良反应发生率为8.00%,与对照组的12.00%对比差异无统计学意义(P>0.05)。两组躯体功能、心理功能、社会功能、人际关系评分对比差异无统计学意义(P>0.05)。结论铅中毒患儿分别采用囗服二巯丁二酸和静滴依地酸钙钠进行治疗均可获得明显的临床疗效,均能有效提高患儿的生活质量,且安全性无明显差异,临床中可依据患儿的实际情况选择具体的治疗方式。     

依地酸钙钠对驱铅治疗的评价和探 讨

目的研究探讨依地酸钙钠对驱铅治疗的临床作用机制。方法该院于2006年8月-2012年8月接收并诊断铅中毒患者共计350例，对其采用依地酸钙钠进行驱铅治疗方案，研究探讨其临床作用机制，观察治疗不良反应，统计数据并进行分析和评价。结果350例铅中毒患者在治疗之后贫血症状明显改善，体内血红蛋白的含量均增加，平均增加（19±13．5）g／L，有1例患者在用药之后出现过敏反应，其余患者的其他症状消失，基本恢复正常，总有效率为98．28％。结论依地酸钙钠对驱铅治疗的临床作用效果明显，不良反应轻且易控制，因此依地酸钙钠治疗铅中毒在临床上值得进一步研究与探讨。     

HILIC-ELSD法测定盐酸多巴酚丁胺注射液中亚硫酸氢钠和依地酸二钠的含量

目的：建立亲水作用色谱-蒸发光散射检测器联用测定盐酸多巴酚丁胺注射液中亚硫酸氢钠和依地酸二钠含量的方法。方法：采用ZIC—HILIC柱（4．6mm×150mm,5μm）;100mmol·L^-1乙酸胺溶液（pH6．0）为流动相A,乙腈为流动相B,梯度洗脱;蒸发光散射检测器：漂移管温度45℃,气体压力40psi;流量0．5mL·min^-1。结果：亚硫酸氢钠在0．8—6．2mg·mL^-1范围内呈良好的线性关系,平均回收率99．1％,RSD为0．6％;依地酸二钠在0．08～0．50mg·mL^-1浓度范围内线性良好,平均回收率99．5％,RSD为0．4％。结论：所建方法简便、灵敏度高,重现性好,可用于盐酸多巴酚丁胺注射液中亚硫酸氢钠和依地酸二钠的含量测定。     

碘杂环化合物IHC-72、利多卡因及维拉帕米抗心律失常作用的比较

在大鼠和豚鼠整体模型上,比较观察了等毒剂量(1/ LD₅₀)的IHC-72、利多卡因和维拉帕米对乌头碱、哇巴因致心脏毒性的保护作用,以及对急性缺血再灌注心律失常和缺血心肌室颤阈的影响。IHC-72抗乌头碱致大鼠心脏毒性作用,与利多卡因相当,而比维拉帕米强;IHC-72抗哇巴因致豚鼠心脏毒性作用,与利多卡因相当而比维拉帕米弱;对提高大鼠缺血电室颤阈值的作用,IHC-72比利多卡因及维拉帕米弱;对预防大鼠急性缺血再灌注的心律失常作用,三者作用近似。     

Acute poisoning with gold cyanide

A case of deliberate ingestion of an electroplating solution containing gold cyanide is described. Despite the use of an antidote, and supportive treatment for cyanide poisoning, the patient died after 13 hours. Sublethal cyanide and high red blood cell gold levels suggest acute gold toxicity as the most likely cause of death. Evidence for this is discussed and recommendations are made for the treatment of cyanide poisoning.     

The efficacy and adverse effects of dicobalt edetate in cyanide poisoning

Introduction: Dicobalt edetate is one of a number of cobalt compounds that have been studied in the treatment of cyanide poisoning, their efficacy being based upon the fact that cyanide combines with cobalt to form relatively non-toxic complexes. Inorganic cobalt salts are quite toxic (cyanide and cobalt antagonise one another's toxicity) and complexes such as dicobalt edetate were studied with the aim of identifying compounds that were less acutely toxic, but which retained the antidotal properties of cobalt salts. The proprietary preparation, Kelocyanor?, contains free cobalt and glucose as well as dicobalt edetate.

Objective: The aim of this study was to evaluate the published evidence for the efficacy and adverse effects of dicobalt edetate.

Methods: A Pubmed search was undertaken for the period 1961–September 2015. The search terms were “dicobalt edetate”, “cobalt edetate” and “Kelocyanor”, which produced 24 relevant citations. A review of the references in four relevant books (L'intoxication cyanhydrique et son traitement, Clinical and Experimental Toxicology of Cyanides, Antidotes for Poisoning by Cyanide and Antidotes) produced three further relevant papers, making a total of 27 papers.

Efficacy of dicobalt edetate: There is evidence from animal pharmacodynamic studies that dicobalt edetate is an effective cyanide antidote in experimental animals. Some 39 cases of human poisoning treated with dicobalt edetate have been reported, but in only nine cases were blood cyanide concentrations measured, although administration of dicobalt edetate procured survival in four of the seven patients with concentrations in the lethal range (>3.0?mg/L). It is unlikely that death in any of the adequately documented fatal cases was attributable to treatment failure with dicobalt edetate, as it is probable that they all had suffered anoxic brain damage before treatment could be initiated. Furthermore, in one case, acute gold toxicity contributed substantially to death.

Adverse effects of dicobalt edetate: Adverse effects reported have included hypertension, tachycardia, nausea, retrosternal pain, sweating, palpebral, facial and laryngeal oedema, vomiting, urticaria and/or a feeling of impending doom. Such effects appear to be more prevalent where the antidote has been administered without evidence of substantial systemic poisoning or where other antidotes have been used which might have been expected also to combine with cyanide. Although the adverse effects observed were doubtless unpleasant, and some were severe, no fatal reactions were found.

Conclusions: Dicobalt edetate is an effective cyanide antidote when given to patients with systemic cyanide poisoning, but it has the potential to give rise to adverse reactions, particularly when administered in the absence of intoxication.