蝎子抗蛇毒素+哌唑嗪的临床疗效和安全性而有毒的蝎子独自哌唑嗪(Mesobuthus tamulus)刺痛:随机临床试验开放标签。

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Bawaskar HS, Bawaskar PH值

蝎子抗蛇毒素+哌唑嗪的临床疗效和安全性而有毒的蝎子独自哌唑嗪(Mesobuthus tamulus)刺痛:随机临床试验开放标签。

BMJ。2011年1月5;342:c7136。

PubMed ID
21209062 (在PubMed
]
文摘

目的:表面变质由Mesobuthus tamulus蝎子刺可以导致严重的心血管效应。蝎子抗蛇毒素是一种特定治疗蝎子刺痛。证据的好处蝎子抗蛇毒素及其功效与常用的血管舒张药相比,如哌唑嗪、稀缺。我们评估的有效性哌唑嗪与蝎子抗蛇毒素相结合,与单独哌唑嗪相比,在个人自主风暴引起的蝎子刺痛。设计:前瞻性、开放标签随机对照试验。设置:综合医院住院患者(Bawaskar医院和研究中心买哈德Dist-Raigad被马哈拉施特拉邦,印度)。参与者:七十2年级蝎子表面变质,患者年龄超过六个月,没有心肺或中枢神经系统异常。干预:蝎子抗蛇毒素+哌唑嗪(n = 35)或独自哌唑嗪(n = 35)随机分配的块。治疗没有蒙面。由意图治疗分析。 MAIN OUTCOME MEASURES: The primary end point was the proportion of patients achieving resolution of the clinical syndrome (sweating, salivation, cool extremities, priapism, hypertension or hypotension, tachycardia) 10 hours after administration of study drugs. Secondary end points were time required for complete resolution of clinical syndrome, prevention of deterioration to higher grade, doses of prazosin required overall and within 10 hours, and adverse events. The study protocol was approved by the independent ethics committee of Mumbai. RESULTS: Mean (SD) recovery times in hours for the prazosin plus scorpion antivenom group compared with the prazosin alone groups were: sweating 3 (1.1) v 6.6 (2.6); salivation 1.9 (0.9) v 3 (1.9); priapism 4.7 (1.5) v 9.4 (1.5). Mean (SD) doses of prazosin in the groups were 2 (2.3) and 4 (3.5), respectively. 32 patients (91.4%, 95% confidence interval 76.9% to 97.8%) in the prazosin plus antivenom group showed complete resolution of the clinical syndrome within 10 hours of administration of treatment compared with eight patients in the prazosin group (22.9%, 11.8% to 39.3%). Patients from the antivenom plus prazosin group recovered earlier (mean 8 hours, 95% CI 6.5 to 9.5) than those in the control group (17.7 hours, 15.4 to 19.9; mean difference -9.7 hours, -6.9 to -12.4). The number of patients whose condition deteriorated to a higher grade was similar in both groups (antivenom plus prazosin four of 35, prazosin alone five of 35). Hypotension was reported in fewer patients in the antivenom plus prazosin group (12 of 35, 34.3%) than in the prazosin group (19 of 35, 54.3%), but the difference was not statistically significant. No difference was noted in change in blood pressure and pulse rate over time between two groups. CONCLUSION: Recovery from scorpion sting is hastened by simultaneous administration of scorpion antivenom plus prazosin compared with prazosin alone. TRIAL REGISTRATION NUMBER: CTRI/2010/091/000584 (Clinical Trials Registry India).

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