PDF(Pubmed)
Abstract：
Cholinesterase inhibitors (ChEIs) insecticide poisoning is a serious global health concern that results in hundreds of thousands of fatalities each year. Although inhibition of the cholinesterase enzyme is the main mechanism of ChEI poisoning, oxidative stress is considered the mechanism underlying the related complications. The study aimed to assess the oxidative status of the patients with ChEI insecticide poisoning and the role of L-carnitine as adjuvant therapy in their management. Human studies on the efficacy and safety of L-carnitine in treating insecticide poisoning are limited despite its growing research interest as a safe antioxidant. This prospective study was conducted on eighty patients with acute ChEIs insecticide poisoning admitted to Alexandria Poison Center, Alexandria Main University Hospital, Egypt. Patients were allocated into two equal groups randomly. The L-carnitine (LC) group received the conventional treatment (atropine & toxogonin) and LC and the standard treatment (ST) group received the standard treatment only. Outcome measures were fatality rate, the total administered dose of atropine & toxogonin, length of hospital stay, and the requirement for ICU admission or mechanical ventilation. The study results revealed that malondialdehyde (MDA) significantly decreased in the LC group. Cholinesterase enzyme levels increased significantly after treatment in the LC group than in the ST group. The LC group needed lower dosages of atropine and toxogonin than the ST group. Also, the LC group showed no need for ICU admission or mechanical ventilation. The study concluded that LC can be considered a promising adjuvant antioxidant treatment in acute ChEIs pesticide poisoning.
摘要：
胆碱酯酶抑制剂（ChEI）杀虫剂中毒是一个严重的全球健康问题，每年导致数十万人死亡。虽然抑制胆碱酯酶是ChEI中毒的主要机制,氧化应激被认为是相关并发症的潜在机制。该研究旨在评估ChEI杀虫剂中毒患者的氧化状态以及L-肉碱作为辅助治疗在其治疗中的作用。尽管L-肉碱作为安全抗氧化剂的研究兴趣日益增加，但对其治疗杀虫剂中毒的功效和安全性的人类研究却受到限制。这项前瞻性研究是对亚历山大毒物中心收治的80例急性ChEI杀虫剂中毒患者进行的，亚历山大大学主要医院，埃及。患者随机分为两组。左卡尼汀（LC）组接受常规治疗（阿托品和毒素）和LC，标准治疗（ST）组仅接受标准治疗。结果指标是死亡率，阿托品和毒素的总给药剂量，住院时间,以及ICU入院或机械通气的要求。研究结果表明，LC组丙二醛（MDA）显着降低。LC组治疗后胆碱酯酶水平明显高于ST组。与ST组相比，LC组需要更低剂量的阿托品和弓形素。此外，LC组显示不需要入住ICU或机械通气.该研究得出结论，LC可以被认为是急性ChEI农药中毒的一种有前途的辅助抗氧化剂治疗方法。
