Objective To explore the organ protective effect of reduced glutathione (GSH) on patients with acute severe organophosphorus poisoning.

Methods Clinical medical records of patients with acute severe organophosphorus poisoning were collected through the hospital's electronic medical record system. Based on the inclusion and exclusion criteria, 68 patients were finally selected as the study subjects. They were divided into conventional group and GSH group according to different treatment regimens, with 34 patients in each group. The conventional group received fluid replacement, gastric lavage, diuresis, atropine and pralidoxime chloride for detoxification, and hemoperfusion treatment, while the GSH group was additionally treated with GSH on this basis. The incidences of arrhythmia, ST-T segment changes, and conduction abnormalities during treatment were statistically analyzed in the two groups. The ICU hospitalization time, case fatality rate, use of vasopressors, and mechanical ventilation time were compared between the two groups. The levels of serum cardiac troponin Ⅰ (cTnI), creatine kinase isoenzyme-MB (CK-MB), creatine kinase (CK), lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (HBDH), cholinesterase (CHE), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) before treatment and one week after treatment were compared between the two groups. The Glasgow Coma Scale (GCS) scores of patients in the two groups were evaluated before treatment and one week after treatment.

Results The ICU hospitalization time and mechanical ventilation time in the GSH group were shorter than those in the conventional group, with statistically significant differences (P < 0.05). After treatment, the levels of cTnI, CK-MB, LDH, HBDH, AST, and ALT in the GSH group were lower than those in the conventional group, while the CHE level was higher than that in the conventional group, with statistically significant differences (P < 0.05). During treatment, the incidences of arrhythmia and conduction abnormalities in the GSH group were lower than those in the conventional group, with statistically significant differences (P < 0.05). There was no statistically significant difference in ST-T segment changes between the two groups (P>0.05). After treatment, the motor response score and total GCS score in the GSH group were higher than those in the conventional group, with statistically significant differences (P < 0.05).

Conclusion The use of GSH in the treatment of patients with acute severe organophosphorus poisoning can improve CHE activity, improve the myocardial enzyme profile, protect liver function, reduce cardiac injury, and have an ameliorative effect on nervous system damage (especially in terms of motor response).