CAJ | 학술논문

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。
목적：탐토오사타정대봉독치심기손상적보호작용。방법58례봉독치심기손상환자수궤분위량조，균급여서의상규치료，재차기출상，치료조28례여이오사타정정맥적주，대조조30례여이과당이린산납정맥적주。검측량조심기매보[기산격매(CK)、기산격매동공매(CK-MB)、유산탈경매(LDH)]재입원당천、48 h급7 d후적수평，이초민C반응단백(hs-CRP)이급혈장병이철(MDA)、초양화물기화매(SOD)、백개소6(IL-6)분별재입원당천급7 d후검측변화정황。결과입원시량조환자혈장CK、CK-MB、LDH등심기매지표비교차이무통계학의의(P>0.05)；치료48 h후，치료조심기매각항지표교대조조저，차이유통계학의의(P<0.05)，치료7 d후량조환자심기매각항지표비교，치료조우우대조조，차이유통계학의의(P<0.05)；치료7 d후대조조혈장MDA、hs-CRP、IL-6교치료조고，이SOD교저，차이균유통계학의의(P<0.05)。결론오사타정대봉독치심기손상유교호적보호작용，기궤제가능여항양화응격、항염유관。
Objective To investigate protective effect by ulinastatin for bee venom-induced myocardial damage.Methods A total of 58 patients with bee venom-induced myocardial damage were randomly divided into two groups. Both group received conventional treatment by Western medicine. The treatment group with 28 cases received intravenous drip of ulinastatin, and the control group with 30 cases received intravenous drip of fructose dipllosphate sodium. Myocardium enzymogram levels [creatine kinase (CK), creatine kinase-MB (CK-MB), lactic dehydrogenase (LDH)] were detected in the two groups at admission and after 48 h and 7 d. Changes of high sensitivity C-reactive protein (hs-CRP), serum malonaldehyde (MDA), superoxide dismutase (SOD), and interleukin-6 (IL-6) were detected at admission and after 7 d.Results At their admission, the two groups had no statistical significance in differences of plasma CK, CK-MB, LDH indexes (P>0.05). After 48 h of treatment, the treatment group had lower indexes than the control group, and their difference had statistical significance (P<0.05). After 7 d of treatment, the treatment group had better indexes than the control group, and their difference had statistical significance (P<0.05). The control group had higher plasma MDA, hs-CRP and IL-6, and lower SOD than the treatment group after 7 d. Their differences all had statistical significance (P<0.05). Conclusion Ulinastatin provides good protective effect for bee venom-induced myocardial damage, and its mechanism may be related with anti-oxidative stress and anti- inflammation.