银杏叶提取物治疗有机磷农药中毒并发中毒性心肌炎的临床观察

The clinical effect of shuxuening treatment on organophosphorus pesticide poisoning with toxic myocarditis

目的探讨银杏叶提取物治疗有机磷农药中毒并发中毒性心肌炎的临床效果。方法选择有机磷中毒性心肌炎患者60例为研究对象，通过简单随机方法分为观察组和对照组各30例；对照组给予常规治疗，观察组在常规治疗的基础上给予银杏叶提取物注射液连用14d后检测患者肌酸激酶同工酶（CKMB）、肌钙蛋白（TNI）、白细胞介素石（IL-6）、胆碱酯酶（ChE）以及临床变化。结果观察组与对照组中中毒程度差异无统计学意义（x2=0．630，P=0．730）；同程度有机磷中毒患者中TNI、CKMB、IL-6能较好的反映心肌受损的严重程度，TNI、CK-MB、IL-6随着中毒程度的加重，呈上升趋势，差异有统计学意义（F分别为11．863、4．512、3．774；P分别为0．000、0．015、0．029）。观察组和对照组治疗前TNI、CK-MB、IL-6差异无统计学意义（t=0．408、0．688、-1．342；P=0．694、0．511、0．216），治疗后第4、9、14天，两组TNI、CK-MB、IL-6均有所恢复，但观察组（常规治疗加用银杏叶提取物）的TNI、CK—MB、IL-6第4、9、14天恢复水平均明显优于对照组，差异有统计学意义（第4天：t=8．125、5．128、10．461；P=0．000、0．001、0．000；第9天：t=5．464、4．674、9．510；P=0．001、0．002、0．000；第14天：t=6．162、8．248、5．523；P=0．000、0．000、0．001）。结论在常规治疗有机磷中毒并发中毒性心肌炎的基础上加用银杏叶提取物治疗效果更好，临床值得推广。

Objective To investigate the clinical effect of shuxuening treatment on organophosphorus pesti- cide poisoning with toxic myocarditis. Methods 60 patients with organophosphorus toxic myocarditis were selected in our hospital as the research subjects, and 60 cases were divided into two groups ： observation group （ n = 30 ） and control group（ n = 30）. Control group was given conventional treatment, treatment group was given shuxnening injec- tion 14 days on the basis of conventional treatment. After treatment, creatine kinase isoenzyme （ CKMB ）, troponin （ TNI）, interleukin 6 （ IL - 6 ） and cholinesterase （ ChE ） were compared, and the changes of clinical symptoms were observed at the same time. Results There was no significant difference between the observation group and the control group（ Xz = 0.630, P = 0.730）. The TNI, IL -6, CKMB could reflect the severity of myocardial injury in patients with different degrees of organic phosphorus poisoning, TNI, CK - MB, IL - 6 increased with the degree of poisoning, the differences were statistically significant（ F = 11. 863,4. 512,3. 774 ;P = 0. 000,0. 015,0.029 ）. After treatment for 4, 9,14 days, TnI, CK, CK - MB,levels of IL - 6 in the two groups were recovered, but the recovery levels of TnI, CK - MB and IL - 6 of the observation group significantly better than the control group, the differences were statistically sig- nificant （ Fourth days, t = 8. 125,5.128,10.461 ;P = 0.000,0.001,0. 000 ; Ninth days, t = 5. 464,4. 674,9.510 ;P = 0.001,0.002,0. 000, t = 6. 162,8. 248,5. 523 ; P = 0. 000,0. 000,0. 001 ）. Conclusion Conventional treatment combined with shuxuening in the treatment of organophosphorus pesticide poisoning with toxic myocarditis has better therapeutic effect, it is worthy of promotion.