Treatment Of Hydrogen Sulfide On Cardiovascular Injury Induced By Penehyclidine Hydrochloride

Background In recent years, incidence of acute poisoning induced by hydrogen sulfide occasionally takes place, with the abroad ranges of vacaction. According to the data of World Health Organization, more than 70 kinds of occupation contact hydrogen sulfide frequently, but the poisoning always occurs with dealing sewerage,chemical industry and foodstuff process etc. The case fatality rate of AHSP complicated with cardiovascular injury increases with the aggravated degree of organ dysfunction. The heart damage, cardiac arrhythmia, cardia insufficiency and microcirculation disturbance have great impact on the entire pathogenetic condition, which become one of the main causes of death in organophosphate poisoning patient. The Penehyclidine Hydrochloride has the pharmacologic action of eliminating gland secretion, improving microcirculation, protecting organism protecting organism and regulation of immune response etc. In clinical, it has good therapeutic effect on acute organophosphorus pesticide, applying in the preceding operations and multiple organ injury. Toxic substance is a powerful stimulating factor for organism. It can trigger the production and release of generous inflammatory mediators. It can also induce systemic inflammatory "waterfall-like" reaction. Whether complicating with bacterial infection or not,excessive inflammatory response to cardiovascular injury happened and even multiple organ injury can occur. Therefore, we assume that using Penehyclidine Hydrochloride in AHSP complicated with cardiovascular injury may have good effect. TNF-a is one of the earliest inflammatory factors. on one hand, it can active PMN, release of generous inflammatory mediators, trigger the production, and even induce the systemic inflammatory "waterfall-like" reaction; on the other hand, it can also active the cruor and alexin. Both of them can induce the multiple organ injury especially the cardiovascular injury. And the level of IL-8 have a strong correlation with the PMN of activation。Therefore inhibiting the inflammatory factors. such as TNF-a andIL-8 which play an important role in inflammatory reaction is one of the mechanisms of Penehyclidine Hydrochloride the same in AHSP complicated with cardiovascular injury. Cardiac injury markers such as myocardial enzyme often show abnormal changes after AHSP complicated with cardiovascular injury. It can be one of the indexes to observe the damage prognosis.Objectives①to observe the therapeutic effect of Penehyclidine Hydrochloride on AHSP complicated with cardiovascular injury;②to investigate the influence of Penehyclidine Hydrochloride on the degree of TNF-a and IL-8 in test group;③to investigate the influence of Penehyclidine Hydrochloride on the changes of myocardial enzyme activity;④to discuss the relation between the prognosis of acute Hydrogen Sulfide poisoning and the level of TNF-a and IL-8 activation. Accordingly, we investigate the mechanism which make the Penehyclidine Hydrochloride increase the successful rate of AHSP complicated with cardiovascular injury.Methods 32cases of AHSP complicated with cardiovascular injury in emergency departments of our three hospitals were selected from January,2007 to April,2009, and divided into the control group (16cases) and the test group (16cases) at random. The control group was treated with routine therapeutics and test group was treated with Penehyclidine Hydrochloride plus routine therapeutics. All patients in treatment course were phlebotomized according to the designed time. Serums were gathered through deposition and centrifugation. Utilizing enzyme linked immunossrbent assay method (ELISA),we can measure the degree of TNF-a and IL-8.And recorded the myocardial enzyme activity at the the designed time too. Every parameters were demonstrated with X±S. Two sample-means were compared by t-test. Two sample-rates were compared byχ2-test. SPSS 13.0 software was used to carry on statistical analysis. Difference was regarded as significant when P＜0.05.Results①The degree of TNF-αand IL-8 of the test group was lower than the control group, and the difference was significant, (P＜0.05);②The degree of myocardial enzyme recovery of the test group was superior to that of the control group dependent on Penehyclidine Hydrochloride, and the difference was significant, (P＜0.05).③Penehyclidine Hydrochloride can shorten the time being in the hospital of the the test group than the control, and the difference was significant; but there is no difference in the death rate between the two groups,(P<0.05).Conclusion Penehyclidine Hydrochloride plus routine therapeutics has obvious therapeutic effect on reducing the cardiovascular injury and repressing inflammatory reaction. Which can relax the symptoms in a period of time, make the sufferers out of dangers, and shorten their time being in hospital. Its possible mechanism is inhibiting cGMP in the cell, decreasing the degree of TNF-αand IL-8 combination with the rignt ratio of the cAMP/cGMP. On the other hand, Penehyclidine Hydrochloride can adjust the reaction to various surroundings, decreasing the cardiovascular reaction and the happenings. Our experiment has proved the mechanism that Penehyclidine Hydrochloride can shorten the remedy time and improve the symptom is probable to inhibit the level of TNF-αand IL-8.But there is not enough evidence to explain that it can increase the inflammatory factors remedy successful rate, treatment of Hydrogen Sulfide on cardiovascular injury induced by Penehyclidine Hydrochloride need further observed.