目的 探讨美他多辛联合纳美芬治疗急性酒精中毒的临床疗效及安全性。方法 回顾性选取2020年1月—2022年8月合肥市第三人民医院收治的140例急性酒精中毒患者为研究对象,采用SPSS 22.0进行倾向性评分匹配成功80例,分为对照组和治疗组,每组各40例。对照组静脉滴注盐酸纳美芬注射液,0.2~0.4 mg加入生理盐水250~500 mL。治疗组在对照组基础上静脉滴注美他多辛注射液,600~900 mg加入生理盐水250~500 mL。观察两组患者临床疗效,比较治疗前后两组患者症状消失时间、苏醒时间和住院时间,及氧化应激指标谷胱甘肽(GSH)、丙二醛(MDA)和超氧化物歧化酶(SOD)水平。结果 治疗后,治疗组患者临床有效率显著高于对照组患者(97.50%vs 80.00%,P<0.05)。治疗后,治疗组患者症状消失时间、苏醒时间和住院时间均明显短于对照组患者(P<0.05)。治疗后,两组患者GSH、SOD水平均明显高于治疗前,MDA水平明显低于治疗前(P<0.05),且治疗组患者氧化应激指标水平显著优于对照组患者(P<0.05)。结论 对于急性酒精中毒患者,在盐酸纳美芬治疗的基础上给予美他多辛注射液的临床疗效更为满意,能够有效减轻酒精中毒对机体氧化应激反应的影响,且药物安全性好。

Objective To study the clinical efficacy and safety of metadoxine combined with nalmefene in treatment of acute alcoholism.Methods 140 patients with acute alcoholism in the Third People's Hospital of Hefei from January 2020 to August 2022were selected retrospectively. 80 patients of successful matching of propensity score with SPSS 22.0, and they were divided into control and treatment group, and each group had 40 cases. Patients in the control group was iv administered with Nalmefene Hydrochloride Injection, 0.2 — 0.4 mg added into normal saline 250 — 500 mL. Patients in the treatment group were iv administered with Metadoxine Injection on the basis of the control group, 600 — 900 mg added into normal saline 250 — 500 mL. After treatment, the clinical evaluation was evaluated, and the time of symptoms disappearance, awakening and hospitalization, and the oxidative stress indicators of GSH, MDA and SOD in two groups before and after treatment were compared.Results After treatment, the clinical effective rate of patients in the treatment group was significantly higher than that in the control group(97.50% vs 80.00%, P<0.05). After treatment,the disappearance time of symptoms, awakening time and hospital stay in the treatment group was significantly shorter than those in the control group(P<0.05). After treatment, the levels of GSH and SOD in two groups were significantly higher than those before treatment, while the level of MDA was significantly lower than that before treatment(P<0.05), and the level of oxidative stress index in the treatment group was significantly better than that in the control group(P<0.05).Conclusion For patients with acute alcoholism,the clinical effect of metadoxin injection on the basis of nalmefen hydrochloride is more satisfactory, which can effectively reduce the effect of alcoholism on oxidative stress, and the drug safety is good.

R977

安徽医科大学校科学研究基金资助项目(2021xkj125)