大剂量纳洛酮联合醒脑静对急性一氧化碳中毒患者血清酶指标的影响

Effect of high-dose naloxone combined with Xingnaojing on serum enzyme indexes in patients with acute carbon monoxide poisoning

目的研究大剂量纳洛酮联合醒脑静对急性一氧化碳中毒(ACOP)患者血清酶指标的影响。方法100例研究对象来源于2021年1月至2022年10月急诊科接诊的ACOP患者,并依照随机信封法均分为对照组与试验组,分别给予大剂量纳洛酮治疗与联合醒脑静治疗,比较组间临床疗效、血清酶指标变化、催醒时间、肢体运动恢复时间、住院时间、迟发性脑病发生率及死亡率。结果2组临床总有效率比较(94.00%vs84.00%),差异有统计学意义(P<0.05)。2个疗程后,试验组患者血清酶指标[肌酸激酶(CK)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)、激酸激酶同工酶(CK-MB)]水平较对照组显著降低,抗氧化指标超氧化物歧化酶(SOD)水平较对照组明显升高(P<0.05)。对照组患者催醒时间、肢体运动恢复时间晚于试验组,迟发性脑病发生率高于试验组,住院时间长于试验组,SOD水平升高幅度小于试验组(P<0.05)。结论针对ACOP患者可采用大剂量纳洛酮联合醒脑静治疗方案,其临床获效显著,明显缩短患者催醒时间与肢体运动恢复时间,有利于患者临床症状的缓解与心、肝、肾功能的保护,改善患者预后,建议推广应用。

Objective To investigate the effect of high-dose naloxone combined with Xingnaojing on serum enzyme indexes in patients with acute carbon monoxide poisoning(ACOP).Methods A total of 100 ACOP patients admitted to the Emergency Department of our hospital from January 2021 to October 2022 were divided into control group and experimental group according to the random envelope method.High-dose naloxone was given to all patients,and those in the experimental group were additionally given Xingnaojing.The clinical efficacy,changes in serum enzyme indexes,awakening time,recovery time of limb movement,length of stay,and incidence and mortality of delayed encephalopathy were compared between the two groups.Results The total effective rate in the experimental group was significantly higher than that in the control group(94.00%vs 84.00%,P<0.05).After 2 courses of treatment,serum enzyme indexes,including creatine kinase(CK),lactate dehydrogenase(LDH),aspartate aminotransferase(AST)and creatine kinase-MB(CK-MB)were significantly lower in the experimental group than those in the control group,and the anti-oxidation index superoxide dismutase(SOD)was significantly higher(P<0.05).The awakening time and recovery time of limb movement in the experimental group were significantly earlier than those in the control group,and the length of hospital stay was significantly shorter(P<0.05).The incidence of delayed encephalopathy was significantly lower in the experimental group than that in the control group(2.00%vs 16.00%,P<0.05).The increase in SOD level in the experimental group was significantly greater than that in the control group(P<0.05).Conclusion High-dose naloxone combined with Xingnaojing therapy can be used to ACOP patients,which has a significant clinical effect.It significantly shortens the awakening time and limb movement recovery time of patients,relieves clinical symptoms,protects the heart,liver and kidney function,and promotes the prognosis.Therefore,it is recommended to be popularized and applied.