川芎嗪对有机磷农药中毒心肺复苏后急性脑缺血再灌注损伤的保护作用

Protective effects of tetramethylpyrazine on acute cerebral ischemia/reperfusion injury after cardiopulmonary resuscitation in patients with organophosphorus pesticide poisoning

目的:探讨川芎嗪对有机磷农药中毒心肺复苏后急性脑缺血再灌注损伤的保护作用。方法:将32例患者按顺序随机分为治疗组和对照组。治疗组18例给予川芎嗪2 4 0 mg加质量分数为5 %的葡萄糖2 5 0 ml静脉滴注,1h滴完,其后按上述剂量每日1次,疗程5～7d。对照组除不用川芎嗪外,其他治疗同治疗组。结果:治疗组治疗后显效12例,有效4例,无效2例,总有效率为88.9% ;超氧化物歧化酶(SOD)从治疗前的(94 .5 5±13.0 4 ) k NU/ L上升到(10 2 .4 6±15 .2 2 ) k NU/ L;过氧化脂质(L PO)从(6 .88±1.32 ) μmol/ L 下降到(4.97±1.0 4 ) μmol/ L;血栓素B2 (TXB2 )从(2 11.4 5±2 0 .4 7) ng/ L 降至(12 9.31±14 .6 6 ) ng/ L(P均<0 .0 1)。对照组治疗后显效6例,有效4例,无效4例,总有效率为71.4 % ,两组间差异有显著性(P<0 .0 5 )。两组治疗后静脉血SOD、L PO和TXB2 均有改善,但治疗组改善程度明显优于对照组(P均<0 .0 5 )。结论:川芎嗪能对抗脂质过氧化反应,提高SOD活性,抑制血小板活化,对有机磷农药中毒心肺复苏后脑缺血再灌注损伤有一定保护作用,早期应用可提高脑复苏成功率。

Objective: To evaluate the protective effects of tetramethylpyrazine on acute cerebral ischemia/reperfusion injury after cardiopulmonary resuscitation in patients with organophosphorus pesticide poisoning. Methods: Consecutive thirtytwo patients were randomly divided into treatment group and control group.Eighteen patients in the treatment group were treated with tetramethylpyrazine 240 mg+5% glucose 250 ml infused intravenously for l hour once a day for 57 days. The treatment in the control group was the same as that of the treatment group except tetramethylpyrazine infusion omitted. Results: The therapeutic effects in the treatment group were markedly effective in 12 cases, effective in 4 cases and ineffective in 2 cases, the total effective rate being 88.9%. The effects in the control group were 6, 4, 4 and 71.4% respectively. The differences were significant between the two groups (P<0.05). In the treatment group, superoxide dismutase (SOD) was increased from (94.55±13.04)kNU/L before treatment to (102.46±15.22)kNU/L after treatment, lipid peroxide (LPO) was decreased from (6.88±1.32)μmol/L to (4.97±1.04)μmol/L, thromboxin B 2 (TXB 2) was decreased from (211.45±20.47)ng/L to (129.31±14.66)ng/L(all P<0.01). The plasma SOD, LPO and TXB 2 levels were improved in the two groups after treatment and the improvement was more superior to that of the control group. Conclusion: Tetramethylpyrazine has the effect of restraining lipid peroxidation, increasing the activity of SOD, inhibiting the activation of blood platelets and has the protective effect on acute cerebral ischemia/reperfusion injury after cardiopulmonary resuscitation in patients with organophosphorus pesticide poisoning. If it is used earlier, the successful therapeutic rate of cerebral resuscitation can be increased.