丙氨酰谷氨酰胺治疗重度甲拌磷中毒致胃肠功能障碍的临床效果

Clinical effect of alanyl glntamine in the treatment of patients with gastrointestinal function obstacle caused by severe phorate poisoning

目的观察丙氨酰谷氨酰胺注射液治疗重度甲拌磷农药中毒致胃肠功能障碍患者的疗效。方法将80例符合研究条件的重度甲拌磷农药中毒致胃肠功能障碍患者随机分为对照组（40例）和治疗组（40例）。对照组给予禁饮食、阿托品、碘解磷定、抗炎、白蛋白、脂肪乳氨基酸葡萄糖注射液、ω-3鱼油脂肪乳注射液、血液灌流等综合治疗。治疗组在对照组治疗的基础上加用丙氨酰谷氨酰胺注射液。比较两组患者胃肠道功能恢复正常的时间，两组患者胆碱酯酶活力、前白蛋白、白蛋白及总蛋白的变化，解毒药物阿托品及碘解磷定的总用量，以及两组患者入住重症监护室的时间。结果治疗组患者胃肠功能障碍恢复至正常的时间少于对照组，差异有统计学意义（P〈0．05）。给予丙氨酰谷氨酰胺注射液治疗的第3、5、7、10天，治疗组患者的胆碱酯酶活力均明显高于对照组，差异有统计学意义（P〈0．05）。给予丙氨酰谷氨酰胺注射液治疗的第5和10天，治疗组患者的前白蛋白、白蛋白及总蛋白均高于同期对照组指标，差异均有统计学意义（P〈0．05）。治疗组患者的解毒药物总用量（阿托品、碘解磷定）以及在重症监护室的住院时间均低于对照组，差异有统计学意义（P〈0．05）。结论丙氨酰谷氨酰胺注射液对重度甲拌磷农药中毒致胃肠功能障碍患者有良好的治疗效果。

Objective To observe the therapeutic efficacy of alanyl glutamine injection on patients with gastrointestinal function obstacle caused by severe phorate poisoning. Methods A total of 80 eligible patients with gastrointestinal function obstacle caused by severe phorate poisoning were randomly divided into the control group （n=40） and treatment group （n=40）. The control group was treated with the conventional therapy, which included forbidden diet, atropine, pralidoxime iodide, anti-inflammatory, albumin infusion, ω-3 fish oil fat emulsion, protection of organs function, blood perfusion, and Fat Emulsion, Amino Acids （17） and Glucose Injection. The treatment group was treated with alanyl glutamine injection plus the conventional therapy. To observe the time of recovering to normal of gastrointestinal function between the two groups, compared the AChE activity and changes of prealbumin, albumin and total protein of the two groups respectively. Furthermore, the total atropine dosage, the total pralidoxime iodide dosage and ICU stay time between the two groups were also compared. Results The gastrointestinal function recovery time of patients in the treatment group was less than the control group, the difference was statistically significant （P〈0.05）. From the third day of treatment, the serum cholinesterase activity of the treatment group was higher than the control group, the difference was statistically significant （P〈0.05）. On the 5th day and 10th day of the treatment, the prealbumin, albumin and total protein of the treatment group were significantly higher than these indexes of the control group in the same period, the difference were statistically significant （P〈0.05）. The total atropine dosage, the total pralidoxime iodide dosage and ICU stay time in the treatment group were lower than the control group, the difference were statistically significant （P 〈0.05）. Conclusion Alanyl glutamine injection has a great therapeutic effect for gastrointestinal function obstacle patients caused by severe phorate poisoning.