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目的探讨乌司他丁对蜂毒致心肌损伤的保护作用。方法 58例蜂毒致心肌损伤患者随机分为两组,均给予西医常规治疗,在此基础上,治疗组28例予以乌司他丁静脉滴注,对照组30例予以果糖二磷酸钠静脉滴注。检测两组心肌酶谱[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]在入院当天、48 h及7 d后的水平,而超敏C反应蛋白(hs-CRP)以及血浆丙二醛(MDA)、超氧化物歧化酶(SOD)、白介素6(IL-6)分别在入院当天及7 d后检测变化情况。结果入院时两组患者血浆CK、CK-MB、LDH等心肌酶指标比较差异无统计学意义(P>0.05);治疗48 h后,治疗组心肌酶各项指标较对照组低,差异有统计学意义(P<0.05),治疗7 d后两组患者心肌酶各项指标比较,治疗组优于对照组,差异有统计学意义(P<0.05);治疗7 d后对照组血浆MDA、hs-CRP、IL-6较治疗组高,而SOD较低,差异均有统计学意义(P<0.05)。结论乌司他丁对蜂毒致心肌损伤有较好的保护作用,其机制可能与抗氧化应激、抗炎有关。
Objective To investigate the protective effect of ulinastatin on myocardial injury induced by bee venom. Methods Fifty-eight cases of myocardial injury caused by bee venom were randomly divided into two groups, all of which were treated by conventional western medicine. On the basis of this, 28 cases in the treatment group were given ulinastatin intravenously, and 30 cases in the control group were given intravenous drip of fructose diphosphate Note. The levels of CK, creatine kinase (CK-MB) and lactate dehydrogenase (LDH) in the two groups were measured at 48 h and 7 d after admission, while the levels of hypersensitivity C reactive protein (hs-CRP) and plasma malondialdehyde (MDA), superoxide dismutase (SOD), interleukin 6 (IL-6) were detected on the day of admission and 7 d after the change. Results There was no significant difference in CK, CK-MB and LDH among the two groups at admission (P> 0.05). After 48 hours of treatment, the indexes of myocardial enzymes in the treatment group were lower than those in the control group (P <0.05). After treatment for 7 days, the indexes of myocardial enzymes in both groups were better than those in the control group (P <0.05). After 7 days of treatment, the levels of MDA, hs -CRP, IL-6 higher than the treatment group, while the SOD was lower, the difference was statistically significant (P <0.05). Conclusion Ulinastatin has a good protective effect against bee venom induced myocardial injury, and its mechanism may be related to anti-oxidative stress and anti-inflammation.