胃动素对血管灌流大鼠离体胃运动的作用

通过血管灌流大鼠离体胃,探讨胃动素对胃运动的影响。结果表明:(1)胃动素可以明显地兴奋胃窦自发的胃运动;(2)胃动素抗血清可以完全消除胃动素兴奋胃窦运动的作用;(3)阿托品可以阻断胃动素兴奋胃窦运动的作用。上述结果提示,胃动素可特异性兴奋血管灌流大鼠胃窦收缩运动,该作用通过壁内胆碱能神经介导。     

紫外分光光度法测定硫酸阿托品滴眼剂的含量

采用紫外分光光度法测定硫酸阿托品滴眼剂的含量,测定波长为２５６ｎｍ,在０．２￣１．２ｍｇ／ｍｌ浓度范围内吸光度与浓度符合Ｂｅｅｒ’ｓ定律,线性关系良好。     

阿托品对糖尿病人高生长激素血症的作用

对29例糖尿病人行基础状态血生长激素(GH)测定,其中9例升高。此9例中7例有慢性并发症,而20例GH正常者仅4例有慢性并发症(P<0.05)。对9例血GH升高者行阿托品试验(1mg静注),结果表明:注射阿托品后30′血GH即见下降,40′、60′、75′各时相GH仍保持下降趋势,至90′下降最明显,与0′时相比较有显著差异(P<0.05)。试验前后血糖值无明显变化。本试验表明:阿托品具有抑制糖尿病高GH血症的作用,这可能有助于糖尿病慢性并发症,尤其是血管并发症的防治,值得临床进一步观察。     

Endocrine effects of organophosphate antidotal therapy

To determine the endocrine effects of the treatment of organophosphate poisoning, this prospective study was conducted in a university-based emergency department among patients with a history and clinical findings compatible with those of organophosphate poisoning. Thyrotrophin (TSH), free triiodothyronine (FT3), free thyroxine (FT4), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), progesterone (PRG), adrenocorticotropic hormone (ACTH), cortisol, and testosterone (TST) levels were analyzed before and after treatment with atropine and pralidoxime. The Wilcoxon’s sign rank sum (nonparametric) test was used to compare dependent variables before and after treatment. A total of 44 patients (19 male; mean age: 28.5±12.6 y) were enrolled in the study. Patients were hospitalized for 5.4±1.3 days. Posttreatment ACTH, cortisol, PRL, FT3, FSH, and PRG levels were significantly lower than pretreatment levels (P<.05). The decrease in TSH, LH, and TST levels did not reach statistical significance, while FT4 levels increased following the treatment (P<.05). Six patients were diagnosed on admission with sick euthyroid syndrome, and 11 patients who were euthyroid on admission developed sick euthyroid syndrome following treatment. ACTH, cortisol, PRL, FT3, FT4, FSH, and PRG levels are affected by acute organophosphate poisoning. The change in hormone levels may result from the effects of neurotransmitters, from the direct effect of the toxic agent, or from stress associated with events leading to the poisoning incident.     

Short-lasting, Unilateral, Neuralgiform Headache Attacks with Conjunctival Injection and Tearing (SUNCT Syndrome): IV. Respiratory sinus arrhythmia during and outside paroxysms

SUNCT is a headache syndrome characterized by short-lasting (usually 15-120 sec), unilateral head pain paroxysms localized in the peri-ocular area, accompanied by conjunctival injection, lacrimation, nasal stuffiness, rhinorrhea, and subclinical forehead sweating, all on the symptomatic side. A relative bradycardia seems to be an integral part of the paroxysm; a parasympathetic stimulation could theoretically be the causative factor for the bradycardia. In 3 SUNCT patients, vagal nerve function (E:I ratio) has been monitored outside and during pain paroxysms, while 3 other patients could be studied in the attack-free period only. E:I ratio is obtainable in the course of a maximally deep breath and represents the ratio of the longest R-R interval during a 5 sec long expiration to the shortest R-R interval during a 5 sec long expiration. The mean E:I ratio of SUNCT patients outside paroxysms was significantly higher than the mean E:I ratio in an aged-matched control group. The E:I ratio was, however, significantly decreased during paroxysms in comparison with ratios obtained outside the pain paroxysms. After 0.6 mg atropine administration s.c. to one of the patients in the symptomatic phase, the heart rate increased, and the relative bradycardia during headache paroxysm was diminished (but not completely abolished). The E:I ratio was lowered but it was still slightly larger outside than during attacks. The reason for the abrupt and seemingly clear attack-related decrement in E:I ratio together with the previously described relative bradycardia remains enigmatic, however the possibility of increased parasympathetic tone cannot be excluded.     

合理应用阿托品治疗急性有机磷农药中毒的临床研究

目的 :观察阿托品不同给药方式对重度急性有机磷农药中毒 (AOPP)的治疗效果。方法 :随机将 12 2例AOPP患者分为 A、B两组 ,A组 6 3例反复静推阿托品达阿托品化后 ,采用微量泵持续静脉输注 ;B组 5 9例采用反复静推阿托品 ,将治疗前后的疗效、阿托品用量及用药天数进行比较。结果 :阿托品用量及用药天数两组间无明显差异。A组治愈率 (96 .82 %)明显高于 B组 (83.0 5 %) (P<0 .0 5 ) ,死亡率 (3.17%)、阿托品中毒发生率 (1.6 %)、脑水肿发生率 (1.6 %)低于 B组 (P<0 .0 5 )。A组反跳的发生率低于 B组 (P<0 .0 1)。结论 :反复静推阿托品达阿托品化后 ,采用微量泵持续静脉输注阿托品治疗 AOPP效果明显。     

沙林中毒所致姊妹染色单体异常交换频率的分析

目的 :探讨沙林对人类染色体的影响。方法 :在沙林毒性气体事件中 ,检测了 8名暴露者、49名对照者的外周血淋巴细胞姊妹染色单体交换频率 (SCE)并进行了统计学分析。结果 :暴露组的SCE为 (4 916± 1 480 ) /细胞 ,对照组为 (3 76 6±0 6 2 0 ) /细胞 ,经Cochranttest单尾检验 ,P <0 .0 5 ,呈现弱阳性结果。结论 :阳性结果的主要原因是 3名症状严重的暴露者的SCE偏高 ,这可能与在抢救治疗过程中过量使用阿托品 (疑为致畸性药物 )有关 ,沙林估算量和阿托品摄入量之比为 1∶95 ,1∶2 5。但最终还需一些符合逻辑的、合理的实验和更长时间的暴露人群追踪调查的结果来作定论。对有机磷杀虫剂中毒病人的治疗应尽可能地交替和复合使用特效解毒药和胆碱脂酶复能剂 ,尽量减少可能由治疗药物产生的负面影响。     

自主神经张力的变化对三磷酸腺苷终止室上性心动过速的影响

目的 :探讨自主神经张力的变化对三磷酸腺苷 （ATP）终止室上性心动过速 （SVT）的影响。方法 :30例有心动过速病史的患者经食道心房调搏诱发 SVT后 ,随机分为 3组 ,每组 10例。 组 :诱发 SVT后 ,静脉快速推注 ATP（剂量由小到大 ）终止 SVT; 组 :诱发 SVT后 ,先给予异丙基肾上腺素 （2 μg/ m in,5 m in）静脉点滴 ,再用 ATP终止 ; 组 :诱发 SVT后 ,先静脉推注阿托品 （0 .0 4m g/ kg） ,再给予不同剂量的 ATP终止 SVT,ATP的剂量依次为 :0 .15 ,0 .175 ,0 .2 ,0 .2 2 5 ,0 .2 5 ,0 .2 75 ,0 .3,0 .32 5 ,0 .35和 0 .375 mg/ kg,ATP用药间隔时间为 3m in。结果 :ATP终止 SVT的有效剂量在应用异丙肾上腺素、阿托品后都显著高于基础状态下的剂量 （P<0 .0 5 ）。结论 :自主神经张力的变化对 ATP终止室上性心动过速有明显的影响     

人工流产术中丙泊酚和阿托品联合应用临床观察

目的　观察丙泊酚联合阿托品在开展无痛人工流产术中的临床效果。方法　 30 0例行人工流产术患者随机分为 3组 ,每组各 10 0例患者。实验 1为应用丙泊酚组 ,实验 2为应用丙泊酚联合阿托品组 ,对照组为未用药组。结果　应用丙泊酚在人工流产术中镇痛效果确切 (P <0 0 1) ,手术中并不增加出血量 (P >0 0 5 ) ;而丙泊酚和阿托品联合应用可使扩宫更容易 (P <0 0 1)并减少了丙泊酚用量 (P <0 0 5 )。结论　丙泊酚和阿托品联合应用在人工流产术中镇痛效果良好并便于手术     

异丙酚复合阿托品或氯胺酮应用于肠镜检查

目的 比较异丙酚、异丙酚复合阿托品／氯胺酮应用于结肠镜检查的安全性、舒适性及实用性。方法 选择结肠镜患者90例，随机分为A、B、C三组（各30例），A组为异丙酚组，B组为异丙酚复合阿托品组，C组为异丙酚复合氯胺酮组。A组缓慢静注异丙酚（1．0～2mg／kg），B组缓慢静注异丙酚（1．0～2mg／kg）和阿托品（0．5mg）混合液，C组先缓慢静注氯胺酮（0．5～0．8mg／kg），后静注异丙酚（1．0～2mg／kg）。用药至患者无意识，睫毛反射消失后检查开始，后根据手术需要和患者情况追加异丙酚（30～50mg）至手术结束。连续监测并记录麻醉前、手术开始至手术结束时三组患者的SBP、HR、SpO2，术后苏醒时间及异丙酚用量。结果 （1）A组术中心率下降与术前基础值相比差异有非常显著性（P〈0．01）；B、C两组心率麻醉前后差异无显著性（P〉0．05）。（2）A、B两组收缩压与术前基础值相比下降明显，差异有非常显著性（P〈0．01）；C组收缩压麻醉前后差异无显著性（P〉0．05）。（3）本组异丙酚用量相比，B、C两组明显少于A组（P〈0．01）。（4）三组患者对术中不适均无记性，但C组患者有术后轻微躁动，苏醒延迟。结论 这三组药都能减轻患者痛苦，B、C组能减轻异丙酚的心血管副反应，但氯胺酮不利于患者术后迅速苏醒。