还原型谷胱甘肽治疗急性有机磷中毒引起的心肌损害

摘要

Objective:To investigate the effect of giutathionc on myocardial damage caused by acute organophosphorus pesticide poisoning. Methods: A total of 60 patients with acute organophosphorus pesticide poisoning admitted to our hospital were randomly divided into two groups, the treatment groupCn - 30) and the control group (n - 30). Gastric lavagc, fluid replacement, atropinc, PHC, pralidoximc were routinely given in both groups, while the treatment group was additionally given glu-tathionc 2400 mg/d. The levels of cardiac troponin T (cTnT), aspartatc aminotransfcrasc (AST), alaninc aminotransfcrasc (ALT) , crcatinc kinasc (CK) , crcatinc kinasc MB (CK-MB) , lactatc dehydrogenase (LDH) , cholincstcrasc (CHE) and electrocardiogram 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. Glutathionc could significantly decrease those index in the treatment group. Conclusions: Glutathionc have a significant protective effect to myocardial damage caused by acute organophosphorus poisoning.%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GSH 2 400 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.