目的 探讨还原型谷胱甘肽(GSH)联合血液灌流对急性有机磷农药中毒(AOPP)患者症状改善、血清胆碱酯酶(ChE)水平、心肌酶谱及肝功能的影响。方法 回顾性分析2016年10月至2021年10月我院急诊科收治的AOPP患者78例,按方便抽样法抽取2016年1...目的 探讨还原型谷胱甘肽(GSH)联合血液灌流对急性有机磷农药中毒(AOPP)患者症状改善、血清胆碱酯酶(ChE)水平、心肌酶谱及肝功能的影响。方法 回顾性分析2016年10月至2021年10月我院急诊科收治的AOPP患者78例,按方便抽样法抽取2016年10月至2019年4月36例为对照组,抽取2019年5月至2021年10月42例为观察组。所有患者接受常规治疗,对照组在常规治疗基础上给予血液灌流治疗,观察组在对照组基础上给予GSH静脉滴注。观察两种治疗方案对患者症状改善、血清ChE水平、心肌酶谱以及肝功能的影响。结果 观察组总有效率显著高于对照组(85.71%vs. 63.89%,P<0.05);观察组机械通气时间(h:5.48±1.23 vs. 6.20±1.52)、昏迷复醒时间(h:1.97±0.35 vs. 2.29±0.58)、住院时间(d:10.14±1.79 vs. 11.21±2.53)均显著低于对照组(P<0.05);入院24 h、72 h、7 d,观察组血清ChE水平(U/L)显著高于对照组(24 h:946.15±168.49 vs.760.78±152.97;72 h:1351.77±608.31 vs.1085.37±445.69;7 d:3011.49±657.24 vs. 2405.76±598.28,P<0.05)。治疗7 d后,两组血清乳酸脱氢酶、肌酸激酶、谷丙转氨酶、谷草转氨酶、总胆红素水平显著降低,且观察组显著低于对照组[LD(U/L):131.28±35.15 vs. 165.74±43.06,CK(U/L):78.22±20.31 vs. 96.81±25.94、ALT(U/L):70.02±27.83 vs. 84.91±34.22,AST(U/L):63.01±31.58 vs. 76.84±23.91,TBiL(mol/L):36.73±16.41 vs. 49.57±21.86,P<0.05)。结论 GSH联合血液灌流可有效改善AOPP患者的临床症状及肝功能,提高血清ChE水平,有利于心肌酶谱恢复正常,疗效显著且可靠。展开更多
Enzymatic electrolysis cell(EEC)has advantages over microbial electrolysis cell(MEC)due to the needless of microbe inoculation and high-efficiency of enzymatic reaction.In this study,an EEC was first applied to achiev...Enzymatic electrolysis cell(EEC)has advantages over microbial electrolysis cell(MEC)due to the needless of microbe inoculation and high-efficiency of enzymatic reaction.In this study,an EEC was first applied to achieve the effective degradation of halogenated organic pollutants and dichloromethane(CH2Cl2)was utilized as a model pollutant.The results indicate that the degradation efficiency of CH2Cl2 after 2 hr reaction in the EEC was almost100%,which was significantly higher than that with enzyme(51.1%)or current(19.0%).The current induced the continuous regeneration of reduced glutathione(GSH),thus CH2Cl2 was degraded under the catalysis of GSH-dependent dehalogenase through stepwise dechlorination,and successively formed monochloromethane(CH3Cl)and methane(CH4).The kinetic result shows that with a current of 15 mA,the maximum specific degradation rate of CH2Cl2(3.77×10-3 hr-1)was increased by 5.7 times.The optimum condition for CH2Cl2 dechlorination was also obtained with pH,current and temperature of 7.0,15 mA and 35°C,respectively.Importantly,this study helps to understand the behavior of enzymes and the fate of halogenated organic pollutants with EEC,providing a possible treatment technology for halogenated organic pollutants.展开更多
文摘目的 探讨还原型谷胱甘肽(GSH)联合血液灌流对急性有机磷农药中毒(AOPP)患者症状改善、血清胆碱酯酶(ChE)水平、心肌酶谱及肝功能的影响。方法 回顾性分析2016年10月至2021年10月我院急诊科收治的AOPP患者78例,按方便抽样法抽取2016年10月至2019年4月36例为对照组,抽取2019年5月至2021年10月42例为观察组。所有患者接受常规治疗,对照组在常规治疗基础上给予血液灌流治疗,观察组在对照组基础上给予GSH静脉滴注。观察两种治疗方案对患者症状改善、血清ChE水平、心肌酶谱以及肝功能的影响。结果 观察组总有效率显著高于对照组(85.71%vs. 63.89%,P<0.05);观察组机械通气时间(h:5.48±1.23 vs. 6.20±1.52)、昏迷复醒时间(h:1.97±0.35 vs. 2.29±0.58)、住院时间(d:10.14±1.79 vs. 11.21±2.53)均显著低于对照组(P<0.05);入院24 h、72 h、7 d,观察组血清ChE水平(U/L)显著高于对照组(24 h:946.15±168.49 vs.760.78±152.97;72 h:1351.77±608.31 vs.1085.37±445.69;7 d:3011.49±657.24 vs. 2405.76±598.28,P<0.05)。治疗7 d后,两组血清乳酸脱氢酶、肌酸激酶、谷丙转氨酶、谷草转氨酶、总胆红素水平显著降低,且观察组显著低于对照组[LD(U/L):131.28±35.15 vs. 165.74±43.06,CK(U/L):78.22±20.31 vs. 96.81±25.94、ALT(U/L):70.02±27.83 vs. 84.91±34.22,AST(U/L):63.01±31.58 vs. 76.84±23.91,TBiL(mol/L):36.73±16.41 vs. 49.57±21.86,P<0.05)。结论 GSH联合血液灌流可有效改善AOPP患者的临床症状及肝功能,提高血清ChE水平,有利于心肌酶谱恢复正常,疗效显著且可靠。
基金supported by the National Natural Science Foundation of China (Nos. 21576241 and 51678528)Hangzhou Agricultural and Social Development Research Program (No. 20180533B03)
文摘Enzymatic electrolysis cell(EEC)has advantages over microbial electrolysis cell(MEC)due to the needless of microbe inoculation and high-efficiency of enzymatic reaction.In this study,an EEC was first applied to achieve the effective degradation of halogenated organic pollutants and dichloromethane(CH2Cl2)was utilized as a model pollutant.The results indicate that the degradation efficiency of CH2Cl2 after 2 hr reaction in the EEC was almost100%,which was significantly higher than that with enzyme(51.1%)or current(19.0%).The current induced the continuous regeneration of reduced glutathione(GSH),thus CH2Cl2 was degraded under the catalysis of GSH-dependent dehalogenase through stepwise dechlorination,and successively formed monochloromethane(CH3Cl)and methane(CH4).The kinetic result shows that with a current of 15 mA,the maximum specific degradation rate of CH2Cl2(3.77×10-3 hr-1)was increased by 5.7 times.The optimum condition for CH2Cl2 dechlorination was also obtained with pH,current and temperature of 7.0,15 mA and 35°C,respectively.Importantly,this study helps to understand the behavior of enzymes and the fate of halogenated organic pollutants with EEC,providing a possible treatment technology for halogenated organic pollutants.
