奥拉西坦联合胞磷胆碱治疗急性一氧化碳中毒患者的临床研究

Clinical trial of oxiracetam combined with citicoline sodium in the treatment of patients with acute carbon monoxide poisoning

目的观察奥拉西坦联合胞磷胆碱治疗急性一氧化碳中毒患者的临床疗效及其对D-二聚体及肌钙蛋白Ⅰ水平的影响。方法将我院急救的急性一氧化碳中毒患者74例,随机分为对照组37例和试验组37例。对照组给予胞磷胆碱钠0.5 g,每日1次,静脉滴注;试验组给予奥拉西坦4.0 g联合胞磷胆碱钠0.5 g,每日1次,静脉滴注。2组均持续治疗2周。比较2组患者的临床疗效,治疗前后测定血液中D-二聚体、肌钙蛋白Ⅰ(cTnⅠ)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平,记录神志恢复时间、肢体运动恢复时间、住院时间等。结果治疗后,对照组和试验组的有效率分别为78.38%,94.59%,差异有统计学意义(P<0.05)。治疗后,对照组和试验组D-二聚体分别为(241.05±69.71),(171.02±72.69)μg·L^-1,cTnⅠ分别为(0.96±0.43),(0.67±0.40)mg·L^-1,MDA分别为(5.06±2.64),(2.96±2.33)μmol·L^-1,SOD分别为(80.74±13.25),(93.02±15.24)U·L^-1,差异均有统计学意义(均P<0.05)。2组的神志恢复时间、肢体运动恢复时间及住院时间,差异均有统计学意义(均P<0.05)。结论奥拉西坦联合胞磷胆碱对急性一氧化碳中毒患者的疗效显著,可以降低D-二聚体、cTnⅠ水平,改善氧化应激状态,缩短症状缓解时间。

Objective To investigate the efficacy of oxiracetam combined with citicoline in the treatment of acute carbon monoxide poisoning and the effects on the levels of D-dimer and troponinⅠ.Methods Seventy-four patients with acute carbon monoxide poisoning who were first-aid in our hospital were randomly divided into treatment group and control group,37 cases in each group.Control group was given citicoline sodium 0.5 g,once a day,intravenous infusion.Treatment group was given oxiracetam 4.0 g combined with citicoline sodium 0.5 g,once a day,intravenous infusion.The patients in two groups were treated for 2 weeks.The clinical effects of the two groups were compared.The levels of D-dimer,troponinⅠ(cTnⅠ),malondialdehyde(MDA),superoxide dismutase(SOD)in blood were measured,and the recovery time of mind,limb movement and hospitalization time were recorded.Results After treatment,the effective rates of control group and treatment group were 78.38%,94.59%,with significant difference(P<0.05).After treatment,the blood D-dimer in control group and treatment group were(241.05±69.71)(171.02±72.69)μg·L^-1,cTnⅠwere(0.96±0.43),(0.67±0.40)mg·L^-1,MDA were(5.06±2.64),(2.96±2.33)μmol·L^-1,SOD were(80.74±13.25),(93.02±15.24)U·L^-1,all with significant difference(all P<0.05).The mental recovery time,limb movement recovery time and hospitalization time in two groups were with significant difference(all P<0.05).Conclusion Oxiracetam combined with citicoline is effective in the treatment of acute carbon monoxide poisoning,which can reduce the levels of D-dimer and cTnⅠ,improve oxidative stress and shorten the remission time of symptoms.