【作者】 汤雪萍；

【导师】 何跃忠；

【作者基本信息】 中国人民解放军军事医学科学院 ， 卫生毒理学， 2007， 硕士

【摘要】 目的:本实验拟通过敌敌畏染毒比格犬,运用统计学分析,评估活性炭血液灌流(HP)对体内已吸收的敌敌畏的清除效果、对毒物代谢动力学的影响及治疗急性重度敌敌畏中毒的疗效。方法:10只比格犬随机分成对照组(常规治疗)和HP组(常规治疗+HP),通过静脉推注敌敌畏进行染毒,HP组于染毒后1小时行活性炭血液灌流治疗2小时。动态检测两组犬血中毒物浓度及丁酰胆碱酯酶(BuChE)的变化;检测炭肾洗脱液中毒物浓度;观察临床疗效;检测各主要脏器中毒物的含量。利用DAS 2.1.1软件进行毒物代谢动力学分析,采用SPSS 13.0统计软件进行成组t检验。结果:敌敌畏在比格犬体内的分布和清除符合二室开放模型,主要的毒物代谢动力学参数为表观分布容积(Vd)(17.803±10.345)L/Kg、表观血浆半衰期(t1/2)(6.260±3.078)h、血浆毒物总清除率(Cl)(1.955±0.757)L/h/Kg;行HP治疗期间两组代谢动力学参数有显著性差异,平均驻留时间(MRT)、t1/2明显缩短,Cl明显增高;但观察48小时两组血中毒物浓度及代谢动力学参数无显著性差异;活性炭可高效地吸附血中的敌敌畏,但洗脱量仅占机体负荷量的极小部分(<2‰);两组BuChE的变化无显著性差异;观察期间阿托品的用量、出现呼吸衰竭时间、辅助呼吸时间及死亡率均无明显差异。结论:单次HP治疗急性重度敌敌畏中毒的疗效可能不理想。更多还原

【Abstract】 Purpose: To assess the efficacy of hemoperfusion (HP) treatment for beagles with acute severe dichlorvus poisoning by statistic analysis.Methord: Ten beagles with intravenous administration of dichlorvus were divided randomly into control group (without hemoperfusion treatment)and HP group (with hemoperfusion treatment). Serum concentration of dichlorvus and the activity of butyrylcholinesterase were dynamicly measure, the clinical effects were judged, and the amount of toxicant in the main tissue was tested. Toxicodynamics was analyzed by DAS 2.1.1, and the data were statistically analyzed by two-tailed t-test.Results: First, the distribution of dichlorvus fits two-compartment model, the main parameters of toxicodynamics were V(d17.803±10.345)L/Kg,t1/2(6.260±3.078)h and Cl(1.955±0.757)L/h/Kg. Second, comparison of toxicodynamics parameters of two groups was different during two-hour HP treatment, but that was not different during 48 hours. Activated charcoal which could efficiently absorbe the dichlorvus in blood only remove a very little( < 2‰) total body burden of dichlorvus.The activity of butyrylcholinesterase in two groups was not different. During the observation, the cumulative dosages of atropine required, at the beginging of breath failure,the endurance of mechanical ventilation and morality in two groups were not different.Conclusion: One hemoperfusion of activated charcoal may not an ideal therapeutic method for acute severe dichlorvus poisoning.更多还原