还原型谷胱甘肽应用于有机磷农药急性中毒患者对其肝功能及心功能保护研究

Reduced glutathione is applie d in patients with acute organophosphorus pesticide poisoning research to the protection of the liver function and cardiac function

目的:探讨还原型谷胱甘肽应用于有机磷农药急性中毒患者对其肝功能及心功能保护效果。方法:选取2015年9月~2016年12月在成都市第三人民医院接受治疗的急性有机磷农药中毒肝损害患者60例,将患者分为两个组,对照组30例,进行一些日常的治疗。观察组30例,在日常的治疗基础上用还原型谷胱甘肽静点。心肌钙蛋白恢复时间、心肌酶谱恢复时间等指标比较,同时比较肝功能指标改善情况、心功能指标改善情况以及临床疗效。结果:治疗后,观察组症状缓解时间、胆碱酯酶活力恢复时间、心肌钙蛋白恢复时间以及心肌酶谱恢复时间(2.41±1.29d、4.41±1.83d、0.68±0.33d、15.36±5.28d)都显著短于对照组(2.87±1.45d、5.62±1.69d、1.26±0.89d、25.39±6.22d),两组比较差异具有统计学意义(P<0.05);治疗前,两组ALT、AST以及γ-GGT进行比较,差异无统计学意义(P>0.05);治疗后,两组ALT、AST以及γ-GGT都有呈现出降低的趋势,观察组(25.12±5.4%、28.96±8.42%、55.78±3.73%)低于对照组(48.45±3.45%、45.60±12.20%、60.48±4.02%),差异具有统计学意义(P<0.05);治疗前,两组CTnⅠ、CK-MB进行比较,差异无统计学意义(P>0.05);治疗后两组CTnⅠ和CK-MB有所下降,对照组(2.04±0.88μg/L、13.06±4.29U/L)低于观察组(2.42±0.28μg/L、30.61±9.82U/L),差异有统计学意义(P<0.05),治疗后观察组的临床总有效率为93.33%,对照组的临床疗效总有效率为66.67%,两组进行比较差异显著(P<0.05);治疗后,观察组有2例出现胆碱酯酶,对照组有11例出现胆碱酯酶,差异不具有统计学意义。结论:还原型谷胱甘肽用于治疗AOPP所致的心肌损伤,对心脏起到有效地保护作用。

objective：to explore the reduced glutathione is applied in patients with acute organophosphorus pesticide poisoning to protect the liver function and cardiac function.Methods：60 Patients with organophosphorus pesticide poisoning from September 2015 to December 2016 in the third people＇s hospital were randomly all the enrolled patients were divided into two groups, The control group of 30 patients, treatment for patients with some everyday. Observation group of 30 patients, on the basis of daily check with reduced glutathione static point. Myocardial calcium protein recovery time, myocardial enzymes recovery time to compare, at the same time improve liver function index and improve cardiac function index and clinical curative effect. Results：after treatment, the observation group of patients with symptoms of time, time of cholinesterase activity, myocardial calcium protein recovery time, myocardial enzymes recovery time （2.41±1.29d、4.41±1.83d、0.68±0.33d、15.36±5.28d） was significantly shorter than the control group （2.87±1.45d、5.62±1.69d、1.26±0.89d、25.39±6.22d）, is similar between the two groups have statistical significance （P〈0.05）; Before the treatment, two groups of patients of ALT, AST and gamma GGT, differences in no statistically significant （P〉0.05）; After treatment, two groups of patients of ALT, AST and gamma GGT has present a lower trend, observation group （25.12±5.4%、28.96±8.42%、55.78±3.73%）, lower than the control group （48.45±3.45%、45.60±12.20%、60.48±4.02%）, two groups of patients to compare the differences statistically significant （P〈0.05）; Before the treatment, two groups of patients with CTn I, CK-MB, differences in no statistically significant （P〉0.05）; In the two groups after treatment in patients with CTn I and CK-MB decline, in the control group （2.04±0.88μg/L、13.06±4.29U/L）is lower than the observation group（2.42±0.28μg/L、30.61±9.82U/L）, compared with difference was statistically significant（P〈0.05）, the clinical curative effect of observation group after treatment the total effective rate was 93.33%, the clinical curative effect of control group total effective rate 66.67%, significant difference comparing the two groups （P〈0.05）; After treatment, the observation group 2 patients appeared cholinesterase, cholinesterase observed in control group there were 11 patients, without exception, compared with statistical significance. Conclusion：reduced glutathione is used in the treatment of AOPP caused by myocardial injury, effectively protect the heart.