红花黄色素治疗急性一氧化碳中毒早期心肌损伤的临床研究

Clinical Study on Effects of Early Application of Safflower Yellow Pigment on Cardiac Function in Acute Carbon Monoxide Poisoning

目的:探讨应用红花黄色素治疗急性一氧化碳中毒(ACOP)早期心肌损伤的临床疗效。方法:选择ACOP患者126例,将患者随机分成对照组和治疗组。所有患者于入院后(中毒后3 h内)即抽血检测CK、CK-MB、c Tn I、IMA水平,治疗后6 h、3 d、7 d复查。对照组给予吸氧、高压氧、降低颅内压、促进脑细胞代谢等处理。治疗组在此基础上加用红花黄色素注射液静脉滴注,连用7 d。结果:治疗前CK、CK-MB、c Tn I均在正常范围,IMA水平低于正常值。治疗后6 h,治疗组IMA升高较对照组明显。对照组CK、CK-MB、c Tn I较治疗组升高明显,差异有统计学意义(P<0.05)。治疗后3 d,两组CK、CK-MB、IMA水平恢复到正常范围,c Tn I水平仍较高,但对照组高于治疗组,差异均有统计学意义(P<0.05)。治疗后7 d,c Tn I水平与治疗后6 h、治疗后3 d比较明显好转,但对照组仍高于治疗组,差异均有统计学意义(P<0.05)。ACOP患者早期心肌损伤程度与IMA水平呈负相关(r=-0.568,P=0.001)。结论:红花黄色素可降低ACOP患者早期c Tn I、IMA水平,减轻心肌损伤程度,改善患者预后,缩短病程。

Objective： To study clinical effects of early application of safflower yellow pigment on cardiac function in pa- tients with acute carbon monoxide poisoning （ACOP）. Method： The 126 patients with ACOP were randomly divided into control group and treatment group. All the patients were admitted （within 3 h after poisoning）： blood detection of CK, CK-MB, cTnI, I- MA, and re-examination these indexes 6 h, 3 d and 7 d after treatment. The control group was given oxygen therapy, hyperbaric oxygen, reducing intracranial pressure, and promotes brain cell metabolism process. Besides these treatments, the treatment group received safflower yellow injection by intravenous drip once a day, for 7 days. Results： Before treatment, CK, CK-MB, cTnI were in the normal range, the level of IMA is lower than the normal value. After 6h treatment, treatment group IMA increased significantly compared with the control group. The level of CK, CK-MB, cTnI in the control group were significantly increased in treatment group （P〈0.05）. 3 days after treatment, both two groups of CK, CK-MB, IMA returned to the normal range, while the level of cTnI was still high, but the control group was higher than the treatment group, the difference was statistically significant （P〈0.05）. After 7 days treatment, the level of cTnI improved, but the control group was still higher than the treatment group, and the difference was statistically significant （P〈0.05）. ACOP was negatively correlated with early myocardial damage and IMA level （r=-0.568, P=0.001）. Conclusions： the safflower yellow can decrease the level of cTnI and IMA, and can reduce the severity of myocardial injury, and improve the prognosis of patients, shorten the course of disease.