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目的:观察舒血宁注射液对急性重度一氧化碳中毒(ASCOP)患者脑氧利用率(O_2UC)、丙二醛(MDA)及超氧化物歧化酶(SOD)的影响及意义。方法:选择我院2015-01-2017-01期间住院的120例ASCOP患者,按随机数字表法分为对照组、治疗组。对照组给予紧急高压氧舱治疗,药物给予缓解脑水肿、营养脑细胞、清除氧自由基等常规治疗;治疗组在对照组基础上加用舒血宁注射液20ml静滴,qd,连用2周。两组患者均于治疗前及治疗后6h、24h、48h、7d经颈内动脉及颈内静脉采血测血气分析,根据公式计算O_2UC=SaO_2-SvO_2/SaO_2,同时检测MDA及SOD。比较两组患者治疗前后O_2UC、MDA、SOD的变化;观察治疗14d后患者临床症状改善情况;随访60d时迟发性脑病(DEACMP)的发生率。结果:两组患者O_2UC逐渐下降,6h、24h、48h均差异有统计学意义(P<0.05),7d时降至正常;MDA逐渐下降,24h、48h、7d均差异有统计学意义(P<0.05);SOD逐渐升高,24h、48h、7d均差异有统计学意义(P<0.05);14d时治疗组总有效率(95%)明显高于对照组(85%,P<0.05);60d时治疗组DEACMP发生率(5.0%)低于对照组(11.7%,P<0.05)。结论:舒血宁注射液治疗ASCOP可减轻氧化应激反应,能有效降低O_2UC及MDA水平,升高SOD水平,临床疗效显著,可降低DEACMP的发生率,改善患者预后,提高患者生存质量。
Objective: To observe the effect and significance of Shuxuening injection on cerebral oxygen utilization (O_2UC), malondialdehyde (MDA) and superoxide dismutase (SOD) in patients with acute severe carbon monoxide poisoning (ASCOP). Methods: A total of 120 ASCOP patients admitted to our hospital from January 2015 to January 2016 were divided into control group and treatment group according to random number table. The control group was treated with emergency hyperbaric oxygen chamber, drugs were given to relieve cerebral edema, nutrition brain cells, oxygen free radicals and other routine treatment; the treatment group in the control group with Shuxuening injection 20ml intravenous infusion, qd, once every 2 weeks . Blood samples were collected from both groups before and 6h, 24h, 48h and 7d after treatment. Blood samples were collected for blood gas analysis by internal carotid artery and internal jugular vein. O_2UC = SaO_2-SvO_2 / SaO_2 was calculated according to the formula. MDA and SOD were also detected. The changes of O 2 UC, MDA and SOD before and after treatment were compared between two groups. The improvement of clinical symptoms was observed after 14 days of treatment. The incidence of delayed encephalopathy (DEACMP) at 60 days of follow-up was observed. Results: O 2UC gradually decreased in both groups, with a significant difference at 6h, 24h and 48h (P <0.05), and decreased to normal at 7d. MDA gradually decreased at 24h, 48h and 7d (P < 0.05). The SOD increased gradually at 24 h, 48 h and 7 d (P <0.05). The total effective rate (95%) in the treatment group was significantly higher than that in the control group (85%, P <0.05) on the 14th day. The incidence of DEACMP in the treatment group (5.0%) was lower than that in the control group (11.7%, P <0.05) on the 60th day. Conclusion: Shuxuening injection can reduce the oxidative stress response, reduce the levels of O 2 UC and MDA, and increase the level of SOD. The clinical curative effect is significant, which can reduce the incidence of DEACMP, improve the prognosis of patients and improve the quality of life of patients.