血必净注射液对急性有机磷中毒性心血管损伤的干预研究.docVIP

血必净注射液对急性有机磷中毒性心血管损伤的干预研究 　　作者：王颖,荣廷,邹艳果,李锦绣 作者单位：山东大学第二医院急诊科， 济南 250033 　　【摘要】 目的 观察血必净注射液对急性有机磷中毒性心血管损伤患者外周血中性粒细胞核转录因子?kappa B(NF?ΚB)的活化程度及损伤预后的影响。方法 将70例急性有机磷中毒合并心血管损伤患者随机分为阳性对照组(35例)和实验组(35例)，用免疫酶组织化学法检测其外周血中性粒细胞NF?ΚB的活化程度，并观察患者血清心肌酶活性值的变化。结果 ①实验组死亡率低于对照组(P0.05);②对照组NF?ΚB活化程度高于实验组(P0.05);③血必净注射液呈剂量依赖性地抑制中性粒细胞NF?ΚB的活性(P0.05);④实验组血清心肌酶活性值恢复程度优于对照组，且与血必净注射液用量呈剂量依赖性(P0.05)。结论 早期联合应用血必净注射液和常规治疗药物，可改善急性有机磷中毒并发心血管损伤患者的预后，提高救治成功率。 　　【关键词】 血必净注射液,有机磷中毒,心血管系统,损伤,免疫组织化学,核转录因子?ΚB 　　To observe the effects of Xuebijing injection on nuclear factor? kappa B activation of PMN and the prognosis of cardiovascular injury. Methods 70 cases of acute organophosphate poisoning complicated with cardiovascular injury were divided into the positive control group (35 cases)and the test group(35 cases) at random. The enzyme labeled immunohistochemical method was used to determine the NF?ΚB activation degree. Changes of myocardial enzyme were also observed. Results ① Death rate of the test group was lower than that of the control group(P0.05). ② The NF?ΚB activation degree of the control group was higher than that of the test group(P0.05).　③ Xuebijing injection suppressed the activation of NF?ΚB on dosage(P0.05). ④ The degree of myocardial enzyme recovery of the test group was superior to that of the control group and was dose?dependent on Xuebijing injection(P0.05). Conclusion Xuebijing injection in combination with routine therapies has obvious efficiency on increasing the success rate of acute organophosphorus pesticide poisoning patients complicated with cardiovascular injury. 　　Key words: Xuebijing Injection,Organophosphate poisoning,Cardiovascular systerm,Injuries,Immunohistochemistry,Nuclear factor?kappa B 　　近年，急性有机磷农药中毒并发心血管损伤的病死率随器官功能损伤程度的增加而升高，心脏损害、心律失常、心功能不全、微循环障碍等对整个病情影响极大，已成为有机磷中毒患者死亡的主要原因之一[1]。本研究应用血必净注射液联合常规治疗药物对急性有机磷中毒并发心血管损伤患者进行治并心血管损伤患者，按入院顺序随机分为常规治疗组(阳性对照组)和血必净注射液治疗组(实验组)。实验组又根据血必净注射液的治疗剂量分成实验亚组Ⅰ(100?mL组)和实验亚组Ⅱ(150?mL组)，另设健康体检者为阴性对照组。阳性对照组共35例，其中男16例，女1