CAJ | 학술논문

目的：比较垂体后叶素(Pit)对百草枯中毒患者的疗效。方法收集大连医科大学附属第一医院2009年1月~2013年5月收治的百草枯中毒患者,均于基层医院给予洗胃后收入院,采用随机数字表法将34例患者分为对照组和Pit组,每组17例,Pit组在给予洗胃前即静点Pit,对照组注入等量生理盐水,两组患者均予以导泻、白陶土、甲基强的松龙、血液灌流等治疗。观察入院后第3天及第1、2、4周肺部CT的动态改变,并测定治疗前及治疗后第3天及第1、2、4周血气分析、总胆红素、谷丙转氨酶、血肌酐指标,并测定核因子-资B,基质金属蛋白酶-9指标。结果输注Pit治疗后,Pit组中毒患者肺影像学表现病变较对照组轻；Pit组第2、4周动脉氧分压指标均高于对照组(P<0.05)；Pit组第1、2、4周总胆红素水平、谷丙转氨酶水平指标均低于对照组(P<0.05)；Pit组第1、2周血肌酐明显低于对照组(P<0.05)；入院第5天Pit组金属蛋白酶-9指标低于对照组(P<0.05),并且Pit组12、24、48 h静脉血单核细胞中NF-资B水平均低于对照组(P<0.05)。结论 Pit能减轻百草枯所致肺损伤,取得较好的临床效果,可作为治疗百草枯中毒的辅助药物。
목적：비교수체후협소(Pit)대백초고중독환자적료효。방법수집대련의과대학부속제일의원2009년1월~2013년5월수치적백초고중독환자,균우기층의원급여세위후수입원,채용수궤수자표법장34례환자분위대조조화Pit조,매조17례,Pit조재급여세위전즉정점Pit,대조조주입등량생리염수,량조환자균여이도사、백도토、갑기강적송룡、혈액관류등치료。관찰입원후제3천급제1、2、4주폐부CT적동태개변,병측정치료전급치료후제3천급제1、2、4주혈기분석、총담홍소、곡병전안매、혈기항지표,병측정핵인자-자B,기질금속단백매-9지표。결과수주Pit치료후,Pit조중독환자폐영상학표현병변교대조조경；Pit조제2、4주동맥양분압지표균고우대조조(P<0.05)；Pit조제1、2、4주총담홍소수평、곡병전안매수평지표균저우대조조(P<0.05)；Pit조제1、2주혈기항명현저우대조조(P<0.05)；입원제5천Pit조금속단백매-9지표저우대조조(P<0.05),병차Pit조12、24、48 h정맥혈단핵세포중NF-자B수평균저우대조조(P<0.05)。결론 Pit능감경백초고소치폐손상,취득교호적림상효과,가작위치료백초고중독적보조약물。
Objective To investigate the protective effect of pituitrin (Pit) on the development of paraquat-induced lung injury in patients. Methods A randomized clinical trial analysis was conducted. Clinical analysis of 34 patients with paraquat poisoning admitted to the First Hospital Affiliated to Dalian Medical University from January 2009 to May 2013 were randomly divided into two groups with 17 in each: control group, Pit group. The patients in Pit group were injected with Pit through the vein, and the patients in control group were injected with the same volume of saline. All patients were treated with methylprednisolone, catharsis, white clay and hemoperfusion combined other treatment. Dy-namic change of the chest CT data of 34 patients with lung injuries induced by paraquat poisoning were analyzed retro-spectively every seven days after the administration of Pit, arterial partial pressure of oxygen, serum ALT, SCr levels and the levels of NF-κB and MMP-9 were detected respectively. Results The patients treated with Pit showed redction of pulmonary injury when compared with the patients of control group from change of the chest CT data. Arterial partial pressure of oxygen in Pit group were higher than that of control group at 2 and 4 weeks, serum ALT, Cr levels were lower than those in the control group at 2 and 4 weeks (all P<0.05). Compared with control group, the levels of NF-κB and MMP-9 in Pit group were lower than those in control group at five days (P<0.05). Conclusion These results indicate that the Pit alleviate the lung injury, and clinical results are satisfactory. Therefore, it may be a useful adju-vant in the treatment of paraquat-induced acute lung injury.