丙氨酰谷氨酰胺对重症有机磷中毒患者神经和胃肠功能的影响

Effects of Glutamine Dipeptide on Neurological and Gastrointestinal Function of Severe Organophosphate Poisoning Patients

目的:探讨丙氨酰谷氨酰胺对重症有机磷中毒患者神经和胃肠功能的影响。方法:选择重症有机磷中毒患者46例,按入院先后顺序随机分为对照组和观察组,各23例。对照组患者给予解毒剂阿托品、复能剂氯解磷定、血液灌流以及其他对症处理。观察组患者在对照组基础上给予丙氨酰谷氨酰胺注射液0.5 g/kg,ivgtt,qd。两组患者均连续治疗3 d。比较两组患者中毒症状消失时间、全血胆碱酯酶恢复时间、住院时间及神经和胃肠功能指标。结果:观察组患者中毒症状消失时间、全血胆碱酯酶恢复时间、住院总时间均明显短于对照组,差异有统计学意义(P<0.05)。治疗后,观察组患者血清二胺氧化酶、乳果糖/甘露醇明显低于对照组,血清瓜氨酸含量高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组腓总神经的运动神经传导速度、感觉神经传导速度明显高于对照组,F波潜伏期明显短于对照组,差异均有统计学意义(P<0.05)。结论:丙氨酰谷氨酰胺能促进重症有机磷中毒患者病情缓解,改善肠黏膜功能和神经功能。

OBJECTIVE： To investigate the effects of glutamine on neurological and gastrointestinal function of severe organophosphate poisoning patients. METHODS： 46 patients with severe organic phosphorus poisoning in our hospital were enrolled and randomly divided into control group and observation group, with 23 cases in each group. Control group was given antidote atropine, energy recovery agent pralidoxime chloride, blood perfusion and other symptomatic treatment. Observation group was additionally given Glutamine dipeptide injection 0.5 g/kg, ivgtt, qd, on the basis of control group. Both groups received the treatment for consecutive 3 d. The time of poisoning symptom disappearance, the time of blood cholinesterase recovery, hospitalization time, neurological and gastrointestinal function indexes were compared between 2 groups. RESULTS： The time of poisoning symptom disappearance, the time of blood cholinesterase recovery and hospitalization time of observation group were significantly shorter than those of control group, with statistical significance （P〈0.05）. After treatment, serum diamine oxidase and lactulose/mannitol of observation group were significantly lower than those of control group, while the serum content of citrulline was higher than in control group, with statistical significance （P〈0.05）. After treatment, MCV and SCV of observation group were significantly higher than those of control group, while F wave latency was significantly shorter than control group, with statistical significance （P〈0.05）. CONCLUSIONS： Glutamine dipeptide is helpful to promote remission, improve gastrointestinal and neurological function.