极化液配合黄芪液对急性有机磷农药中毒致心肌损伤的保护作用研究

目的 研究极化液配合黄芪注射液对急性有机磷农药中毒致心肌损伤的保护作用及其机制.方法 81例急性有机磷农药中毒患者轻度中毒者24例、中度中毒者26例和重度中毒者31例,按随机分层原则分为常规治疗组(A组)44例,常规治疗 极化液配合黄芪注射液(B组)37例;采用动力学法和酶联免疫双抗体夹心法(ELISA法)分别对肌酸激酶(CK)、肌酸激酶同功酶(CK-MB)、乳酸脱氢酶(LDH)、肿瘤坏死因子(TNF),白介素-1(IL-1),白介素-6(IL-6)进行检测;心电图检查采用床旁心电图监测.观察各组上述指标治疗前后动态变化情况,并对相关机理进行探讨.结果 入院时A、B两组血浆生化指标和细胞因子明显增高,但组间指标差异无显著性(P＞0.05);治疗48 h,A组血生化指标和细胞因子相对于B组增高差异存在显著性(P＜0.05).床旁24 h动态心电图检测,A组出现严重心电图异常的几率较B组更显著.治疗后7天病人上述指标基本恢复正常.结论 极化液配合黄芪注射液对急性有机磷农药中毒致心肌损伤具有保护作用,极化液帮助恢复心肌正常生理功能,黄芪可能通过抑制TNF和Il等炎性因子作用对心肌细胞起保护作用.

Protective Effects of Polarized Solution and Astragali Solution on Myocardium Damage of Acute Organic Phosphorus Poisoning Patients

Objective To investigate the protective effects of polarized solution and astragali solution on myocardium damage caused by acute organic phosphorus poisoning.Methods 81 acute organophosphate poisoning patients including 24 cases of mild-poisoning,26 cases of midrange poisoning and 31 cases of severe poisoning were randomly divided into two groups:group A(conventional therapy group,n=44),group B(conventional therapy + polarized solution and astragali solution therapy group,n=37);plasma levels of creatine kinase(CK),creatine kinase isoenzymeMB(CKMB),lactate dehydrogenase(LDH)were measured by dynamic method. Plasma levels of tumor necrosis factor(TNF),interleukin-1(IL-1) and interleukin-6(IL-6) were measured by euzymelinked immunosorbent assay method(ELISA).Electrocardiograms were monitored at bedside.The dynamic change of indicators were observed and pathogenesis was discussed.Results Plasma levels of biochemical indicators and cytokine were significantly increased in both two groups.There is no significantly difference between group A and B(P>0.05).48 hours after treatment,plasma levels of biochemical indicators and cytokine in group A were significantly higher than that in group B(P<0.05).Severity abnormal appearance of Electrocardiograms were also significantly higher in group A.Seven days after treatment,plasma levels of such indicators were near to normal.Conclusion Polarized solution and astragali solution have protective effects on the myocardium damage caused by acute organic phosphorus.One of mechanisms might be related to reduce content of inflammatory factor such as TNF and IL.