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目的观察醒脑静联合乌司他丁治疗急性一氧化碳中毒(acute carbon monoxide poisoning,ACOP)的疗效及治疗后患者血清氧自由基水平变化。方法 70例ACOP患者随机分为治疗组与对照组各35例,对照组在保持呼吸道通畅、维持正常血压、降低颅压等常规治疗基础上于入院1～2h内行高压氧治疗1次;治疗组在对照组治疗基础上静脉滴注乌司他丁和醒脑静注射液,观察2组显效时间,治疗14d后评定2组疗效,并检测2组治疗前及治疗第3,7,14天血清超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-PX)活性和丙二醛(malondialdehyde,MDA)水平。结果治疗组有效率94.28%高于对照组80.00%(P<0.05),显效时间(15.2±3.4)h较对照组(28.1±6.3)h短(P<0.05);2组治疗后血清SOD、GSH-PX较治疗前增高(P<0.05),血清MDA水平较治疗前降低(P<0.05),且治疗组改善优于对照组(P<0.05)。结论乌司他丁联合醒脑静具有清除氧自由基、减轻氧自由基对脑细胞损伤的作用,用于治疗ACOP疗效满意。
Objective To observe the effect of Xingnaojing combined with ulinastatin on acute carbon monoxide poisoning (ACOP) and the level of serum oxygen free radical in patients after treatment. Methods Seventy patients with ACOP were randomly divided into treatment group (n = 35) and control group (n = 35). The control group was treated with hyperbaric oxygen for 1 to 2 hours on the basis of routine therapy such as maintaining airway patency, maintaining normal blood pressure and reducing intracranial pressure. On the basis of the control group, ulinastatin and xingnaojing were injected intravenously. The effective time of the two groups was observed. After 14 days of treatment, the two groups were evaluated. The serum levels of the two groups before treatment and on the 3rd, Superoxide dismutase (SOD), glutathione peroxidase (GSH-PX) activity and malondialdehyde (MDA) were measured. Results The effective rate of the treatment group was 94.28% higher than that of the control group (80.00%, P <0.05), and the effective time (15.2 ± 3.4) h was shorter than that of the control group (28.1 ± 6.3) h GSH-PX increased (P <0.05), serum MDA decreased (P <0.05), and the treatment group improved better than the control group (P <0.05). Conclusion Combination of ulinastatin and xingnaojing can scavenge oxygen free radicals and reduce the effect of oxygen free radicals on brain cell injury, and is effective in treating ACOP.