王双豹,韩永燕,李佳,杨俊礼,王维展
WANG Shuangbao,HAN Yongyan,LI Jia,YANG Junli,WANG Weizhan

• 1:河北医科大学附属哈励逊国际和平医院急诊科

摘要(Abstract)：

目的:探讨还原型谷胱甘肽(GSH)对急性重度一氧化碳中毒(ACOP)伴心肌损伤的治疗效果。方法:98例ACOP患者均分为观察组和对照组,对照组患者常规给予氧疗、脱水降颅压、营养脑细胞治疗,观察组在对照组治疗的基础上给予GSH静脉滴注(2 400 mg/d),2组患者均连续治疗7 d;记录2组患者治疗前后的心电图异常发生率,比较治疗前后2组患者的中性粒细胞/淋巴细胞比值(NLR)、血清肌钙蛋白(cTnI)及肌酸激酶同工酶(CK-MB)水平。结果:治疗前,2组患者NLR比值、血清cTnI及CK-MB水平及心电图异常发生率比较,差异无统计学意义(P>0.05);治疗后观察组患者血清cTnI、CK-MB水平显著低于对照组(P<0.05);治疗后,对照组心电图异常发生率高于观察组,差异有统计学意义(P<0.05)。结论:GSH能有效治疗一氧化碳中毒对心肌的损伤,其机制可能与降低NLR有关。
Objective: To investigate the therapeutic effect of reduced Glutathione( GSH) on myocardial damage caused by acute carbon monoxide poisoning( ACOP). Methods: 98 patients with ACOP were randomly divided into observation group and control group. The control group was given oxygen therapy,dehydration therapy on intracranial pressure,and nutritional therapy for brain recovery,while the observation group was additionally given GSH IV Therapy( 2400 mg/d). The changes of myocardial enzyme spectrum,cardiac troponin I( cTnI),neutrophil to lymphocyte ratio( NLR) and electrocardiogram( ECG) were analyzed and compared between the two groups during the 7-day treatment. Results: Before treatment,there were no statistically significant differences in NLR,cardiac cTnI,creatine kinase MB( CK-MB) and ECG abnormality between two groups( P > 0. 05). After the treatment,levels of cardiac cTnI and CK-MB in the observation group were significantly lower than those in the control group( P < 0. 05) and the abnormal rate of ECG in the control group were significantly higher than those in the observation group( P < 0. 05). The difference was statistically significant( P < 0. 05). Conclusion: Reduced GSH can effectively treat myocardial damage caused by ACOP,which can be the result of NLR reduction.

关键词(KeyWords)： 还原型谷胱甘肽;一氧化碳;中毒;性粒细胞/淋巴细胞比值;心肌损伤;血清;肌钙蛋白;肌酸激酶同工酶
reduced glutathione;carbon monoxide;poisoning;neutrophil to lymphocyte ratio;myocardial damage;serum;troponin;creatine kinase isoenzyme

Abstract:

Keywords:

基金项目(Foundation): 河北省卫生计生委员会科研基金(20170234)

作者(Author): 王双豹,韩永燕,李佳,杨俊礼,王维展
WANG Shuangbao,HAN Yongyan,LI Jia,YANG Junli,WANG Weizhan

DOI: 10.19367/j.cnki.1000-2707.2018.08.019

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