还原型谷胱甘肽治疗急性有机磷中毒引起的心肌损害

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GSH2 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。

Glutathione Used to Treat Myocardial Damage Caused by Acute Organophosphorus Pesticide Poisoning

To investigate the effect of glutathione on myocardial damage caused by acute organophosphorus pesti- cide 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 replace- ment, atropine, PHC, pralidoxime were routinely given in both groups, while the treatment group was additionally given glu- tathione 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 elec- trocardiogram 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 signifi- cant protective effect to myocardial damage caused by acute organophosphorus poisoning.