急性一氧化碳中毒应用舒血宁及磷酸肌酸钠前后检测缺血修饰白蛋白的意义

Effect of Shuxuening combined with creatine phosphate sodium in detecting ischemia modified albumin on acute severe carbon monoxide poisoning

目的:探讨舒血宁联合磷酸肌酸钠对急性重度一氧化碳中毒(acute severe carbon monoxide poisoning,ASCOP)患者缺血修饰白蛋白水平(Ischemia modified albumin,IMA)的影响及其疗效比较。方法 :选择ASCOP患者66例随机分为常规组及治疗组,入选者治疗前、治疗后6 h、3 d分别抽取静脉血检测心肌酶、c Tn I、IMA。结果:治疗前两组IMA显著降低,而心肌酶、c Tn I无明显改变。治疗后6 h,治疗组IMA升高较常规组明显(P<0.05)。两组心肌酶、c Tn I逐渐升高,组间比较差异无统计学意义(P>0.05)。治疗后3 d,常规组c Tn I较治疗组升高明显(P<0.05)。两组心肌酶、IMA恢复正常水平,组间比较差异无统计学意义。治疗后3 d c Tn I与治疗后6 h比较明显好转。结论:ASCOP患者早期给予舒血宁联合磷酸肌酸钠治疗,可改善中毒性心肌损伤,具有心肌保护作用,IMA水平可作为心肌缺血及药物治疗的评价指标。

Objective Study of Shuxuening combined with sodium phosphocreatine on acute severe carbon monoxide poisoning with ischemia modified albumin level and its curative effect in patients. Methods 66 cases of ASCOP patients were randomly divided into routine group and treatment group, all patients were detected for myocardial enzymes, cTnI, IMA before treatment, after treatment 6 h and 3 d. Results IMA was significantly decreased before treatment, while no significant changes occurred in myocardial enzymes and cTnln levels. After treatment for 6 h, IMA in treatment group was higher than conventional group （P 〈 0.05）. Myocardial enzymes and cTnI gradually increased, the two groups had no difference （P 〉 0.05）. After treatment for 3d, cTnI level of normal group increased obviously compare with the treatment group （P 〉 0.05）. Myocardial enzymes, IMA restored to the normal level （P 〉 0.05）. The level of cTnI after treatment for 3 d improved compare with 6 h. Conclusion Treatment of early ASCOP patients by Shuxuening combined with sodium phosphocreatine significantly improve the recovery of myocardial injury poisoning. The level of IMA can be used as evaluation index of myocardial ischemia and drug treatment.