丁苯酞联合高压氧治疗对急性重型一氧化碳中毒患者乳酸清除率及氧化应激反应的影响

Effects of butylphthalide combined with hyperbaric oxygen on lactate clearance rate and oxidative stress response in patients with acute severe carbon monoxide poisoning

目的观察丁苯酞联合高压氧治疗对急性重型一氧化碳中毒(ASCMP)患者乳酸清除率及氧化应激反应的影响。方法将2019年2月至2020年12月在河南科技大学第一附属医院就诊的82例患者按随机法分为观察组和对照组,每组41例。两组患者入院后予高压氧综合治疗,观察组同时加用丁苯酞,持续治疗2周后,比较两组患者的24 h乳酸清除率(24 h LCR)、清醒时间、迟发性脑病(DEACMP)发生率、氧化应激指标、认知功能及自理能力。结果治疗后,观察组超氧化物歧化酶(SOD)高于对照组,丙二醛(MDA)低于对照组(P<0.05);观察组简易智能精神量表(MMSE)、标准日常生活能力Barthel(BI)指数高于对照组(P<0.05);观察组24 h LCR高于对照组,清醒时间及DEACMP发生率低于对照组(P<0.05)。结论丁苯酞联合高压氧治疗可以帮助ASCMP患者提高24 h LCR、优化氧化应激反应,具有较高的应用价值。

【Objective】To observe the effects of butylphthalide combined with hyperbaric oxygen on lactate clearance rate(LCR)and oxidative stress response in patients with acute severe carbon monoxide poisoning(ASCMP).【Methods】A total of 82 patients with ASCMP treated in the hospital were randomly divided into observation group and control group between February 2019 and December 2020,41 cases in each group.Both groups were treated with hyperbaric oxygen for comprehensive treatment after admission.On this basis,observation group was treated with butylphthalide.After 2 weeks of continuous treatment,24 h lactate clearance rate(24 h LCR),awake time,incidence of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP),oxidative stress indexes,cognitive function and self-care ability were compared between the two groups.【Results】After treatment,superoxide dismutase(SOD)in observation group was higher than that in control group,while malondialdehyde(MDA)and homocysteine(Hcy)were lower than those in control group(P<0.05).The scores of mini-mental state examination(MMSE)and Barthel Index(BI)in observation group were higher than those in control group(P<0.05).24 h LCR in observation group was higher than that in control group,awake time and incidence of DEACMP were lower than those in control group(P<0.05).【Conclusion】Butylphthalide combined with hyperbaric oxygen can increase 24 h LCR and optimize oxidative stress response in ASCMP patients,with high application value.