果糖二磷酸钠对急性重度有机磷农药中毒心肌损伤早期指标的影响

目的：探讨果糖二磷酸钠对急性重度有机磷农药中毒（ASOPP）患者早期心肌损伤指标的影响。方法：选择ASOPP患者82例,随机分为对照组41例和治疗组41例,所有患者于入院后（患者中毒后3h内）即抽血检测肌钙蛋白I（cTnI）、缺血修饰白蛋白水平（IMA）和肽素（Copeptin）水平,治疗后6h和24h复查。对照组给予洗胃、静脉推注阿托品、胆碱酯酶复能剂等治疗;治疗组在常规治疗基础上加用果糖二磷酸钠10g,2次/d,静滴。结果：治疗组总有效率明显高于对照组。治疗后6h,对照组IMA、Copeptin较治疗组升高,治疗后24h,IMA、Copeptin水平逐渐降至正常水平;而治疗组cTnI水平较对照组低,2组比较差异有统计学意义（P〈0.05）。结论：急性重度有机磷农药中毒患者早期出现心肌损伤,应尽早给予果糖二磷酸钠干预可降低患者cTnI、IMA、Copeptin水平,减轻心肌损伤并能改善患者预后。

Effect of fructose diphosphate sodium on early marker of myocardial injury in acute severe organophosphorus pesticide poisoning

Objective：To investigate the effect of fructose diphosphate sodium on early markers of myocardial injury in acute severe organophosphorus pesticide poisoning.Method：82 ASOPP patients were randomly divided into treatment group and conventional group.All patients were detected blood of cTnI,IMA,Copeptin on admission（with 3 hours after poisoning）,6h and 24h after treatment.The conventional group received gastric lavage,intravenous injection of atropine,cholinesterase reactivator treatment.The treatment group combined with Fructose Diphosphate Sodium 10g static drops two times a day on the base of conventional treatment.Result：The total effective rate of treatment group was significantly higher than conventional group.6h after treatment,the level of IMA,Copeptin of treatment group was higher than that of the conventional group.24h after treatment,the level of IMA,Copeptin decreased.The level of cTnI of the treatment group was lower than that of the conventional group.The two groups had statistical significance（P〈0.05）.Conclusion：To the patients with early myocardial injury in acute severe organophosphorus pesticide poisoning,giving Fructose Diphosphate Sodium as early as possible can reduce cTnI,IMA,Copeptin levels,relieve myocardial damage and improve the prognosis.