血必净对急性有机磷农药中毒患者多脏器损伤的保护作用及其机制

目的 探讨血必净注射液对急性有机磷农药中毒(AOPP)患者多脏器损伤的保护作用及其机制.方法 将56例AOPP患者(均为口服中毒)随机分为两组:常规治疗组(28例)均给予彻底洗胃、胆碱酯酶复能剂、阿托品及对症支持治疗,血必净治疗组(28例)在常规治疗的基础上加用血必净注射液.观察两组治疗前和治疗1、3、5、7 d后血清胆碱酯酶(AChE)活性、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、尿素氮(BUN)、肌酐(Cr)及内毒素(LPS)、肿瘤坏死因子(TNF)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平的变化.结果 治疗3 d后,与常规治疗组比较,血必净治疗组AChE活性明显好转(P<0.05),AST、ALT、CK-MB、LDH、BUN、Cr及LPS、TNF、IL-6、IL-8水平明显降低(P<0.05,P<0.01);治疗7 d后,血必净治疗组上述指标基本恢复正常,与常规治疗组比较差异有统计学意义(P<0.01).结论 血必净注射液对AOPP患者多脏器具有保护作用,其机制主要通过减少炎症介质的分泌来实现.

Protective effects and its mechanism of Xuebijing injection on multiple organ damage patients with acute organophosphorus poisoning

Objective To investigate the protective effects and its mechanism of Xuebijing on multiple organ dysfunction syndrome (MODS) caused by acute organophosphorus poisoning (AOPP). Methods 56 patients with severe AOPP were randomly divided into 2 groups: routine treatment group and Xuebijing plus routine treatment group. The serum of acetylcholinesterase (AChE) activity, the plasma levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), lactate dehydrogenase(LDH), creatine phosphokinase isoenzyme(CK-MB), blood urea nitrogen(BUN), creatinine(Cr), lipopolysaccharide (LPS), tumor necrosis factor (TNF), interleukin-6 (IL-6) and interleukin-8 (IL-8) were detected before the treatment and 1,3,5,7 days after the treatment in 2 groups and in healthy group during physical examination. Results After 1,3,5,7 days of treatment, the AChE activity and the outcomes of arterial blood gas analysis in Xuebijing treatment group were much better than those of routine treatment group (P<0.05), the other above indexes in Xuebijing treatment group were decreased more significantly than those of routine treatment group (P<0.05,P<0.01). Conclusion Xuebijing has protective effects on the MODS caused by AOPP, and its mechanisms of which might be related to its inhibitory effects on LPS, TNF and IL-6, IL-8 secretion.