丙氨酰谷氨酰胺治疗甲拌磷中毒致胃肠功能衰竭的疗效

Effects of alanyl glutamine in treatment of gastrointestinal failure caused by phorate poisoning

目的观察丙氨酰谷氨酰胺注射液治疗重度甲拌磷中毒致胃肠功能衰竭的疗效。方法将80例重度甲拌磷中毒致胃肠功能衰竭患者随机分为对照组(n=40)和治疗组(n=40)。对照组给予常规综合治疗。治疗组在对照组基础上加用丙氨酰谷氨酰胺治疗。比较两组胃肠道功能恢复正常的时间,两组治疗后胆碱酯酶、前白蛋白、白蛋白及总蛋白的变化,以及解毒药物的总用量及入住重症监护室(ICU)的时间。结果治疗组的胃肠道功能恢复快于对照组(P<0.05)。治疗3~10 d后,治疗组的胆碱酯酶活性均高于对照组(P<0.05);在治疗第5 d和第10 d,治疗组的营养学指标均高于对照组(P<0.05)。治疗组的解毒药物总用量及在ICU住院时间均低于对照组(P<0.05)。结论丙氨酰谷氨酰胺对重度甲拌磷中毒致胃肠功能衰竭有良好的治疗效果,能促进胆碱酯酶活性的恢复,改善患者的营养状况,减少解毒药物的用量,对患者的恢复有促进作用。

Objective To observe the effects of alanyl glutamine in the treatment of gastrointestinal failure caused by phorate poisoning. Methods A total of 80 patients with gastrointestinal failure caused by severe phorate poisoning were selected and randomly divided into a control group and a treatment group （n =40, respectively）. The control group was treated with routine comprehensive therapy. The treatment group was additionally treated with alanyl glutamine. The gastrointestinal function recovery time, the changes in cholinesterase, prealbumin, albumin and total protein after treatment, the total dosage of detoxification drugs and the length of stay （LOS） in intensive care unit （ICU） between the two groups were compared. Results The gastrointestinal function recovery in the treatment group was faster than that in the control group （P 〈 0.05）. After 3-10 days of treatment, the cholinesterase activity in the treatment group was higher than that in the control group （P 〈 0.05）; on the 5th and 10th day of the treatment, the nutritional indexes in the treatment group were higher than those in the control group （P 〈 0.05）. The total dosage of detoxification drugs in the treatment group and the LOS in ICU were less and shorter than those in the control group（P 〈 0.05）. Conclusion Alanyl glutamine has good effects in the treatment of gastrointestinal failure caused by severe phorate poisoning and can promote the recovery of cholinesterase activity, improve the nutritional status of patients and reduce the dosage of detoxification drugs, and is helpful for the recovery of patients.