OBJECTIVETo investigate effectiveness of scopolamine on the acute severe chlorphenamidine poisoning patients.

METHODS72 cases of acute severe chlorphenamidine poisoning patients were divided into I and II groups by the principle of a 1:1 sampling according to the order of admission. The I group (36 cases) were treated with traditional multimodality therapy, including gastrolavage, catharsis, using reductant-oxidant (methylthioninium chloride and vitamin C), and symptomatic treatment. The II group were treated with traditional multimodality therapy and scopolamine at the same times. Blood methemoglobin were measured at 0, third, seventh, twelfth, twenty-fourth hour, serum troponin I (CTnI) and creatine kinase isoenzyme (CK-MB) levels at third, seventh, twenty-fourth, forty-eighth hour, hepatic and renal functions at third, twenty-fourth, forty-eighth hour, and electrocardiogram (ECG) were evaluated every 4 hours in 3 days after hospitalization on all patients. The two groups of patients were compared the efficacy and change detection of targets.

RESULTS31 patients (86.11%) recovered and 5 patients (13.89%) died in I group. All 36 cases recovered in II group. The recovery rate of II group was distinctively higher than that in I group (P < 0.05) and the difference was statistically significant (P < 0.05). The average recovery time and the length of hospital stay in II group were sharply shorter than those in I group (P < 0.01) and the difference was statistically significant (P < 0.05). Serum CTnI levels between seventh hour and forty-eighth hour, serum CK-MB levels between third hour and forty-eighth hour and methemoglobin concentration at third, seventh, twelfth, twenty-fourth hour were apparently lower in II group, and the difference was statistically significant (P < 0.05). The abnormal rates of hepatic and renal functions in II group were distinctively lower than those in I group and the difference was statistically significant (P < 0.05). The abnormal rates of ECG in the second and third day in II group were respectively 38.89% and 11.11%, and were lower than those in I group (64.71%, 38.71%). The difference was statistically significant (P < 0.05).

CONCLUSIONScopolamine has the excellent treatment effect on acute severe chlorphenamidine poisoning patients and protec their hearts, livers, and kidneys. It complements the deficiency of reductant-oxidants, and combination of the two drugs can form the synergy effect.