丙氨酰谷氨酰胺对重症有机磷中毒患者神经和胃肠功能的影响

摘要

目的：探讨丙氨酰谷氨酰胺对重症有机磷中毒患者神经和胃肠功能的影响。方法：选择重症有机磷中毒患者46例，按入院先后顺序随机分为对照组和观察组，各23例。对照组患者给予解毒剂阿托品、复能剂氯解磷定、血液灌流以及其他对症处理。观察组患者在对照组基础上给予丙氨酰谷氨酰胺注射液0.5 g/kg，ivgtt，qd。两组患者均连续治疗3 d。比较两组患者中毒症状消失时间、全血胆碱酯酶恢复时间、住院时间及神经和胃肠功能指标。结果：观察组患者中毒症状消失时间、全血胆碱酯酶恢复时间、住院总时间均明显短于对照组，差异有统计学意义（P＜0.05）。治疗后，观察组患者血清二胺氧化酶、乳果糖/甘露醇明显低于对照组，血清瓜氨酸含量高于对照组，差异有统计学意义（P＜0.05）。治疗后，观察组腓总神经的运动神经传导速度、感觉神经传导速度明显高于对照组，F波潜伏期明显短于对照组，差异均有统计学意义（P＜0.05）。结论：丙氨酰谷氨酰胺能促进重症有机磷中毒患者病情缓解，改善肠黏膜功能和神经功能。%OBJECTIVE:To investigate the effects of glutamine on neurological and gastrointestinal function of severe organo-phosphate poisoning patients. METHODS:46 patients with severe organic phosphorus poisoning in our hospital were enrolled and ran-domly divided into control group and observation group,with 23 cases in each group. Control group was given antidote atropine,en-ergy recovery agent pralidoxime chloride,blood perfusion and other symptomatic treatment. Observation group was additionally given Glutamine dipeptide injection 0.5 g/kg,ivgtt,qd,on the basis of control group. Both groups received the treatment for consecutive 3 d. The time of poisoning symptom disappearance,the time of blood cholinesterase recovery,hospitalization time,neurological and gastrointestinal function indexes were compared between 2 groups. RESULTS:The time of poisoning symptom disappearance,the time of blood cholinesterase recovery and hospitalization time of observation group were significantly shorter than those of control group,with statistical significance (P<0.05). After treatment,serum diamine oxidase and lactulose/mannitol of observation group were significantly lower than those of control group,while the serum content of citrulline was higher than in control group,with sta-tistical significance (P<0.05). After treatment,MCV and SCV of observation group were significantly higher than those of control group,while F wave latency was significantly shorter than control group,with statistical significance(P<0.05). CONCLUSIONS:Glutamine dipeptide is helpful to promote remission,improve gastrointestinal and neurological function.