乌司他丁治疗重度有机磷农药中毒的临床研究

Study on clinical of Ulinastatin in treating patients with Acute Organophosphorus Poisoning

目的观察乌司他丁(UTI)在治疗重度有机磷农药中毒(AOPP)患者中的疗效。方法收治的重度AOPP患者23例随机分为研究组11例和对照组12例,两组患者均接受常规治疗,研究组患者在常规治疗的同时接受UTI治疗。观察治疗期间两组患者的心率(HR)、呼吸频率(RR)、体温(T)、白细胞(WBC)计数、C反应蛋白(CPR)、血清胆碱酯酶(ChE)活性、急性生理学与慢性健康状况评分系统II评分(APACHE II)、多脏器功能障碍综合征的发生率(MODS)及28d病死率。结果两组患者治疗后HR、RR、T及WBC均有明显改善,且研究组改善情况优于对照组(P<0.05)。治疗5d后两组患者的血清CPR和ChE明显下降,研究组下降更显著。和对照组相比,研究组患者APACHEII评分显著降低(P<0.05),MODS发生率明显减少(P<0.05),病死率也明显减少(P<0.05)。结论在常规治疗的基础上,加用乌司他丁可以阻断重度AOPP向MODS发展,降低死亡率。

Objective To explore the efficacy of Ulinastatin in treating patients with Acute Organophosphorus Poisoning（AOPP）.Methods Twenty-three patients with AOPP were randomly assigned to the study group and the control group.Patients in the study group were given Ulinastatin treatment plus standard treatment while patients in the control group received standard treatment only.Physical indexes of heart rate,respiratory rate,temperature and white blood cell count,blood biomedical indexes of C-reactive protein and serum cholinesterase activity,the scores of the Acute Physiology and Chronic Health Evaluation II（APACHEII）,incidence of Multiple Organ Dysfunction Syndrome（MODS） and mortality were measured and assessed.Results Physical indexes of HR,RR,T and WBC in both group had improved greatly after treatment,and the improvement of outcome in the study group was better than that in control group（P0.05）.Blood biomedical indexes of CPR and ChE in both groups had declined significantly at day 5 for treatments,and there was better outcome in the study group than in the control group.Score of APACHEII in the study group was lower than that in control group（P0.05）.Incidence of MODS and mortality from the condition in the study group was less than those in control group（P0.05）.Conclusion Ulinastatin could be used to stop the deteriorating of AOPP to MODS and reduce the mortality of the condition based on standard treatment.