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目的:研究盐酸戊乙奎醚(长托宁)对急性重度有机磷中毒(AOPP)患者QT离散度(QTd)及心肌肌钙蛋白I(cTnI)的影响及其意义。方法:选择50例急性重度有机磷农药中毒(AOPP)心肌损伤致害心律失常者,随机分为长托宁治疗组(治疗组)25例,阿托品治疗组(对照组)25例,进行抢救治疗,疗程均为10d。分别检测比较2组治疗前及治疗结束时,cTnI及QTd变化。结果:入院时2组QTd值相比差异无统计学意义,但治疗后2组QTd值均较入院时显著下降,而治疗组较对照组下降更为显著(P<0.05),且心律失常发生率明显低于对照组(P<0.05);入院时2组cTnI值相比差异无统计学意义,但疗程结束时2组cTnI值均较入院时显著下降,而治疗组较对照组下降更为显著(P<0.05)。结论:长托宁可改善急性重度有机磷中毒患者的心肌损害,使QTd下降,减少心律失常的发生,且不良反应小,是一种理想的有机磷农药中毒的解毒剂。
Objective: To study the influence of penehyclidine hydrochloride (QTd) and cardiac troponin I (cTnI) on patients with acute severe organophosphorus poisoning (AOPP) and its significance. Methods: A total of 50 acute apomorphosis patients with acute myocardial infarction (AOPP) were randomly divided into two groups: 25 patients in the treatment group and 25 patients in the atropine group (control group) , Treatment are 10d. The changes of cTnI and QTd in two groups before and at the end of treatment were compared. Results: There was no significant difference in QTd value between the two groups at admission, but the QTd values of two groups after treatment were significantly lower than those at admission, while the treatment group decreased more significantly than the control group (P <0.05) and arrhythmia occurred (P <0.05). There was no significant difference in cTnI between the two groups at admission, but the cTnI values of two groups at the end of treatment were significantly lower than those at admission, while the treatment group was more decreased than the control group Significant (P <0.05). CONCLUSION: Penehyclidine is an ideal antidote to organophosphorus pesticide poisoning in patients with acute severe organophosphorus poisoning, which can improve myocardial damage, decrease QTd and reduce arrhythmia.