血液灌流联合二巯基丙磺酸钠及大剂量VitB_6救治急性毒鼠强中毒的临床研究

Clinical study on treating acute tetramine intoxication with hemoperfusion,sodium dimercaptosulphonate and large dose vitamin B_6

目的:研究血液灌流(HP)联合二巯基丙磺酸钠及大剂量VitB6救治急性毒鼠强中毒的临床疗效.方法:59例急性毒鼠强中毒患者分为:A组(n=18),采用常规治疗+二硫基丙磺酸钠治疗;B组(n=20)采用常规治疗+二硫基丙磺酸钠+大剂量VitB6治疗;C组(n=21)采用常规治疗+二硫基丙磺酸钠+大剂量VitB6+HP治疗.结果:①C组与A组及B组相比较疗效更满意,HP联合治疗后血液毒鼠强浓度、心肌酶、APACHEⅡ评分、脑电图评分均有降低(P<0.01);C组与A组及B组患者比较,相同时期内血液毒鼠强浓度下降值差异有统计学意义,意识转清醒及抽搐停止时间均显著提前(P<0.01).结论:C组急性毒鼠强中毒疗效优于A组和B组,可作为治疗急性毒鼠强中毒的一种较为理想的方案.

AIM： To explore the clinical curative effect of hemoperfusion （HP）combined with sodium dimercaptosulphonate （Na-DMPS） and large dose vitamin B6 for acute tetramine intoxication（ATI）. METHODS： Fifty-nine ATI patients were divided into 3 groups： group A （n = 18 ） were treated with general therapy; group B （ n = 20） were treated with general therapy and large dose vitamin B6 ; group C（ n =21 ） were treated with general therapy and large dose vitamin B6 and HP. RESULTS： The curative effect of the group C was more satisfactory compared with the group A and B. Blood concentration of tetramine, myocardial enzymes, APACHE Ⅱ score and EEG score in group C were decreased significantly （ P 〈 0. 01 ）. The reduction of blood tetramine concentration in group C was significantly different from that of the other 2 groups. The durations of consciousness recovery and convulsion were shortened significantly （P 〈 0. 01 ）. CONCLUSION： The combined treatment of general therapy and large dose vitamin B6 and blood purification is a desirable strategy to treat ATI.