目的评价长托宁联合阿托品在治疗重症有机磷农药中毒(AOPP)合并心肌损伤中的意义。方法 69例入选患者随机分三组,每组23例,除常规治疗外,I组给予阿托品治疗,Ⅱ组给予长托宁治疗,Ⅲ组给予长托宁+阿托品治疗。于治疗后第7、14天比较三组肌酸激酶同工酶(CK-MB)和肌钙蛋白I(cTnI)的变化。结果治疗后三组CK-MB和cTnI值均较治疗前下降,Ⅲ组下降更明显,与Ⅰ、Ⅱ组比较,差异有统计学意义(P<0.05)。结论长托宁联合阿托品在治疗重症AOPP合并心肌损害中,CK-MB、cTnI恢复较快,是治疗重症AOPP合并心肌损害的理想治疗方案。 Objective To evaluate the significance of combination of penehyclidine and atropine in the treatment of severe organophosphorus pesticide poisoning (AOPP) combined with myocardial injury. Methods Sixty-nine patients were randomly divided into three groups (n = 23 each). In addition to conventional treatment, patients in group I received atropine, group II received penehyclidine and group III received penehyclidine and atropine. The changes of three groups of CK-MB and cTnI were compared on the 7th and 14th day after treatment. Results After treatment, the levels of CK-MB and cTnI decreased in all three groups compared with those before treatment. The decrease in group Ⅲ was more obvious than that in group Ⅰ and Ⅱ (P <0.05). CONCLUSION: In the treatment of severe AOPP complicated with myocardial damage, the combination of penehyclidine and atropine can recover CK-MB and cTnI rapidly and is an ideal treatment for severe AOPP complicated with myocardial damage.