| 徐 牛,姜应波,李 扬,祝 鑫,陈永存,陈 齐,冯习坤.丙氨酰谷氨酰胺联合血浆置换治疗重症有机磷中毒的疗效分析[J].,2019,19(11):2175-2178 |
| 丙氨酰谷氨酰胺联合血浆置换治疗重症有机磷中毒的疗效分析 |
| Therapeutic Effect of Alanyl-glutamine Plus Plasma Exchange in Treating Severe Organophosphate Poisoning |
| 投稿时间：2018-10-24 修订日期：2018-11-21 |
| DOI：10.13241/j.cnki.pmb.2019.11.038 |
| 中文关键词: 丙氨酰谷氨酰胺 血浆置换 有机磷中毒 |
| 英文关键词: Alanyl-glutamine Plasma exchange Organophosphate poisoning |
| 基金项目:湖南省卫计委科研项目(B2016151) |
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| 中文摘要: |
| 摘要 目的：探讨丙氨酰谷氨酰胺联合血浆置换治疗重症有机磷中毒的临床疗效。方法：将2010年1月～2017年1月在我科因急性有机磷农药中毒进行治疗的83例患者纳入研究，并将其随机分为观察组及对照组，观察组42例患者，对照组41例患者。两组患者均给予常规治疗及血浆置换治疗，观察组患者额外给予丙氨酰谷氨酰胺治疗，观察期为7天。对比两组的临床疗效、并发症的发生情况、治疗前后黏膜屏障功能及血液生化指标的变化。结果：观察组患者昏迷时间短于对照组，而ChE恢复时间早于对照组，差异具有统计学意义(P＜0.05)。观察组肝功能不全及消化道出血发生率低于对照组，且差异具有统计学意义(P＜0.05)。治疗7天后，两组二胺氧化酶(diamine oxidase，DAO)及D-乳酸、白蛋白(albumin，Alb)、总蛋白(total protein，TP)、天冬氨酸转氨酶(asper- tate aminotransferase，AST)、丙氨酸转氨酶(alanine transaminase，ALT)、肌酐(creatinine，Cr)水平均较治疗前降低，谷氨酰胺(glu- tamine，Gln)水平均较治疗前升高，观察组血浆DAO及D-乳酸水平低于对照组患者，Gln、Alb、TP水平高于对照组，AST、ALT、Cr水平低于对照组，差异具有统计学意义(P＜0.05)。结论：丙氨酰谷氨酰胺联合血浆置换能够促进重症有机磷中毒患者恢复，减少消化系统并发症发生，保护胃肠道黏膜。 |
| 英文摘要: |
| ABSTRACT Objective: To study the therapeutic effect of alanyl-glutamine plus plasma exchange in treating severe organophos- phate poisoning. Methods: 83 patients with severe organophosphate poisoning who were treated in our department from Jan.2013 to Jan. 2017 were enrolled in this study and randomly divided into the observation group (42 cases) and the control group (41 cases). Both groups were treated with conventional therapy and plasma exchange treatment, and the observation group were additionally treated with alanyl-glutamine. The observation period was 7 days. The therapeutic effect, incidence of complications, gastrointestinal barrier function and biochemical markers before and after treatment were evaluated and compared between two groups. Results: The period of uncon- sciousness of observation group was significantly shorter than that of the control group, and the cholinesterase(ChE) recovery was signifi- cantly earlier than that of the control group(P＜0.05). The incidence of liver dysfunction and hemorrhage of gastrointestinal tract of ob- servation group were significantly lower than those of the control group (P<0.05). At 7 days after treatment, the plasma levels of DAO, D-lactate, TP, AST, ALT, Cr in both group were significantly lower than those before treatment, while the plasma level of Gln displayed contrary trend. In addition, the plasma levels of DAO, D-lactate, AST, ALT and Cr of observation group were significantly up-regulated comparted with the control group(P＜0.05), while up-regulation of the plasma level of AST, ALT, Cr were observed in observation group compared with those of the control group(P<0.05). Conclusion: Alanyl-glutamine plus plasma exchange can improve the recovery of pa- tients with severeorganophosphate poisoning by reducing the incidence of complications of the digestive system and protecting the gas- trointestinal mucosa. |
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