SU1766412A1 - Method for treating chronic intoxication with acrylates - Google Patents

Abstract

The invention relates to medicine, in particular to occupational hygiene and occupational pathology, and can be used to treat patients with chronic acrylate intoxication. The purpose of the invention is to reduce the duration of treatment and provide a stable therapeutic effect. For this purpose, unitiol 5 ml is administered intramuscularly 1 time per day for 5 days, 10% solution of tocopherol acetate 1 ml and cytochrome C 5 ml for 10 days by repeated courses every 8 months. 3 tab.

Description

The invention relates to medicine and can be used in occupational pathology for treating patients with chronic acrylate toxicity. Acrylic acid compounds, when inhaled into the human body by inhalation (in the form of vapor), through the skin (by direct contact) or enterally, can cause both acute and chronic poisonings, mainly through professional contact.

First of all, the tissues most sensitive to oxygen deficiency suffer: the central nervous system, the heart muscle, the liver, the bone marrow.

The defeat of these organs in the form of persistent, severe astheno-vegetative syndrome, insufficiency of the heart muscle and liver detoxification function, as well as severe dystrophic processes of the mucous membrane of the upper respiratory tract are the main cause of persistent disability in chronic acryl poisoning.

Treatment by known methods is not very effective. As a closest solution, one can consider a method that includes the introduction of phytopreparations, vitamin E, phenobarbital and befungin (Prevention of the hematotoxic effect of acrylonitrile. Guidelines, M., 1985). However, this method is not effective enough, because does not affect some pathogenesis mechanisms.

The aim of the proposed method is to reduce the treatment time and provide a stable therapeutic effect.

This goal is achieved by the fact that a complex of antioxidant preparations and membrane protectors is administered intramuscularly to a patient with manifestations of chronic toxicity with acrylates intramuscularly; namely, unithiol in the amount of 5 ml for 5 days, alpha-tocopherol acetate 10% 1 ml and cytochrome C 5 ml for 10 days, repeated courses 1 time in 8 months.

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The therapy of chronic intoxication with acrylates is proposed for the first time, covering all the main pathogenesis stages of acrylic compound exposure to the organism, moreover, the known preparation unitiol acts as a donor of sulfhydryl groups in the scheme as a replacement therapy; Cytochrome C, first used for the treatment of intoxication, is used as a source of macroergs and tissue anhygdioxant and Vitmin E (alpha-tocopherol acetate) as a stabilizer of cell membranes.

Treatment was carried out for workers with work experience in contact with acrylates from 6 to 10 years.

The following groups were identified: 10 people with chronic acrylate toxicity; 22 people with suspected chronic intoxication with acrylates and 15 people with initial clinical manifestations of intoxication (moderate asteno-vegetative syndrome and autonomic neuralgia of the upper extremities).

The treatment by the proposed method was carried out in 32 patients, general strengthening and symptomatic therapy (B vitamins, massage, FTL, etc.) in 15 patients (control). A 3-year ka- aa- nestic observation of the spontaneous restoration of impaired body functions in 10 workers who had been in contact with acrylates for at least 6 years and changed their place of work (within the factory, but out of contact with acrylates) was also carried out; this group did not receive treatment.

The results of applying the proposed method, control and without treatment are presented in Table. one.

PRI me R 1. Patient B., 36 years old. Ventilator repairman, work experience in contact with acrylates for 7 years at the time of hospitalization, x

Clinical examination data: complaints of headache, drowsiness, constant feeling of fatigue, not passing over the weekend and during the holidays, irritability, pain in the hands. Objectively, asthenic symptoms, general hyperhidrosis, unstable red dermographism were pronounced.

Blood pressure is 155/100 HR 100 per 1 min, heart sounds are sharply muffled, emphasis 11 is on the aorta. Liver 2.5 cm protrudes from under the edge of the costal arch, dense.

The general mood background is lowered: elements of depression.

On EEG, signs of impaired repolarization, with capillary scapia, a spastic-ethonic condition, a tendency to venous stagnation, moderate pericapillary edema. Electrosensitivity on cysts and feet is reduced (20 mA).

Clinical Diagnosis: Chronic

profintoxication with acrylates (Astheno-vegetative syndrome, autonomic-sensory polyneuropathy of the upper limbs, hepatosis, chronic lumbosacral radiculitis),

The course of treatment: cerebrolysin in / m number 15, pantokrin, Relanium, Sustanon, massage. There was a slight improvement in well-being at the end of the inpatient stay; with

5 subsequent rapid deterioration within 1.5 months. Objectively from the side of the vegetative nervous, cardiovascular system without significant dynamics. Re-hospitalization.

0 The diagnosis is the same. Asthenic symptoms are pronounced on admission. On the ECG, the dynamics is moderately negative compared to 1987. According to the systems, the data are the same. The treatment was carried out according to the following scheme: Cavinton IM, Cerebrolysin, Relanium, Vitamin E, Vitamins C, B6, Glucose IV, DDT on the hands. By the time of discharge from the hospital, there was a slight improvement in well-being, a decrease in the degree of astheno-vegetative symptoms that continued for 2 months after discharge from the hospital. From the hands of virtually no dynamics.

3- hospitalization. The same diagnosis.

5 Upon admission, asthenic and vegetative symptoms are expressed. On ECG, sinus bradycardi, a decrease in voltage in standard and reinforced leads. On an ICH, moderate arterial hyper0 tensile with normal IOC and UPS ratios. Increase the size of the liver to 2.5 cm, thymol sample 13. sublimate 2, 15, sugar 3, 8, cholesterol 4.0. Changes in the structure of the liver were not detected on ultrasound. With the tep5 lizionnom study of the hands and feet, reducing blood flow in the distal. The treatment was carried out according to the proposed scheme: unitiol, vitamin E, cytochrome C and symptomatic therapy. By the time of expulsion from the hospital, the state has improved significantly, the mood has increased, the elements of depression have disappeared, the vegetative and asthenic symptoms have decreased, the electrical sensitivity has increased

5 hands and feet. On the part of the cardiovascular system, normalization of the heart rhythm and repolarization processes was observed.

Biochemical data: normalization of detoxification function

liver biochemistry, increased the number of thiol groups in the serum, decreased the level of rhodanides in the blood and urine, increased the level of cholesterol, increased to normal peroxidase activity of blood neutrophils.

By the time of the fourth hospitalization, the effect of the therapy was largely preserved. Some deterioration in well-being came 9 months after the end of the course of therapy.

The duration of the effect of therapy with the proposed method was studied by periodic examinations of patients, receiving a course of treatment during repeated hospitalizations at the clinic of the institute and upon departure of the staff of the institute to the factory.

The results of the study are presented in Table. 2

On the condition that contact with acrylates is terminated with an experience of up to 5 years, restoration of impaired functions is observed in 80-90% of workers within 1-1.5 years. As the prof. length of service is extended to 3-5 years, and only 15-30% of workers have a full recovery. With an experience of over 10 years, spontaneous recovery after cessation of contact with acrylics does not occur. Asthenic and vegetative symptoms, polyneuropathy, persisted; in a part of the examined, changes in the cardiovascular system and the functional state of the liver remained.

The recovery time of impaired functions when applying the therapy by the proposed method occurs within 20-30 days, with traditional therapy for 60-115 days, and with spontaneous recovery for 16-26 months.

The severity of the effect of therapy with the proposed method was studied by periodic examinations of patients who received a course of treatment during repeated hospitalizations at the institute clinic and when the institute employees went to the factory. The average duration of the effect of therapy with the proposed method, depending on the length of work in contact with acrylates, was 5 years - 15-18 months, from 5 to 10 years - 12-16 months, and with work experience of more than 10 years - 8-10 months,

Thus, clinical studies have shown that the treatment by the proposed method provides a quick, with a reduction of 3-4 times, and a complete restoration of the functional state of the body.

The comparative results of complex and monotherapy presented in the table confirm the feasibility of the combined use of drugs according to the proposed scheme, as not only shortening the recovery of impaired body functions in patients with chronic acrylate toxicity, but, as shown by the data of a casamical observation, which gives a more complete and lasting therapeutic effect - not less than 8 months subject to continued contact with acrylates.

Some indicators of the effectiveness of complex and monotherapy in patients with chronic intoxication with salaries (observation period in the hospital for 28 days) are presented in table, 3.

The proposed treatment regimen covers all the main pathogenesis of effects on the body and provides not only detoxification of acrylates, but also provides a pronounced lasting therapeutic effect.

The social effectiveness of the method is that it allows you to prevent disability and thereby reduce the incidence. The treatment of one patient is at least 10 thousand rubles per year. The treatment regimen can be applied both in the clinic and as a dispensary under the supervision of medical personnel.

Taking into account the significant increase in the production of acrylates, which is 10-15% annually and a wide range of industries using acrylic compounds, the proposed objective treatment of chronic intoxication with acrylates can be recommended for specialized research institutes, centers of occupational pathology, medical institutions (medical centers, polyclinics, clinics).

Claims (1)

Invention Formula A method for treating chronic acrylate intoxication, comprising administering tocopherol acetate, characterized in that, in order to shorten the treatment time by providing a stable therapeutic effect, the preparation is administered in the form of a 10% solution of 1 ml in combination with 5 ml of cytochrome for 10 days In addition, 5 ml of unithiol are additionally administered for the first 5 days, the courses are repeated every 8 months. Table 1 table 2 Note: monotherapy groups in 20 patients; combination of unitiol and vitamin E; 30 patients; complex therapy; 60 patients Table 3