中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2012年
11期
811-815
,共5页
刘薇薇%余卫%陈嘉榆%叶更新%刘移民%陈玲珍%陈运贤%张程%钟雪云
劉薇薇%餘衛%陳嘉榆%葉更新%劉移民%陳玲珍%陳運賢%張程%鐘雪雲
류미미%여위%진가유%협경신%류이민%진령진%진운현%장정%종설운
干细胞%百草枯%中毒%呼吸窘迫综合征,成人型
榦細胞%百草枯%中毒%呼吸窘迫綜閤徵,成人型
간세포%백초고%중독%호흡군박종합정,성인형
Stem cells,Paraquat%Poisoning%Respiratory distress syndrom,aclult
目的 探讨脐带间充质干细胞(umbilical cord mesenchymal stem cells,UMSC)治疗急性百草枯中毒致肺损伤的临床疗效和安全性.方法 将2008年12月至2011年12月广州市第12人民医院收治的13例急性百草枯中毒致肺损伤患者分为观察组(5例)及对照组(8例).所有患者均予常规治疗,观察组加用UMSC治疗.应用欧洲重症医学监护医学协会(ESICM)感染相关问题工作组制定的SOFA评分体系,结合我国急性生理学和长期健康评价Ⅱ(acute physiology and chronic health evaluation,APACHEⅡ)对患者进行病情序贯器官衰竭综合评分[SOFA(a)];同时行肺损伤评分(LIS)评价损伤程度.比较两组患者中毒后第1、3、5、7、14及15天后最大SOFA(a)的差异.结果 观察组患者中毒后第15天最大的SOFA(a)评分为(1.80±2.05),明显低于对照组(13.50±7.59),差异有统计学意义(P<0.05);观察组治疗后LIS(0.45±0.27)比治疗前(1.15±0.34)明显下降,也明显低于对照组治疗后(2.94±1.20),差异均有统计学意义(P<0.01).观察组5例患者均存活,复查无诉不适,肝、肾、肺等功能复查正常.肺部CT复查1例患者左下肺后段原病灶部分未完全吸收,其他患者均未见异常.对照组8例患者有1例存活,其余7例均死亡.观察组患者在接受UMSC治疗期间无出现寒战、发热等不良反应.结论 UMSC治疗急性百草枯中毒致肺损伤可能有一定临床应用价值.
目的 探討臍帶間充質榦細胞(umbilical cord mesenchymal stem cells,UMSC)治療急性百草枯中毒緻肺損傷的臨床療效和安全性.方法 將2008年12月至2011年12月廣州市第12人民醫院收治的13例急性百草枯中毒緻肺損傷患者分為觀察組(5例)及對照組(8例).所有患者均予常規治療,觀察組加用UMSC治療.應用歐洲重癥醫學鑑護醫學協會(ESICM)感染相關問題工作組製定的SOFA評分體繫,結閤我國急性生理學和長期健康評價Ⅱ(acute physiology and chronic health evaluation,APACHEⅡ)對患者進行病情序貫器官衰竭綜閤評分[SOFA(a)];同時行肺損傷評分(LIS)評價損傷程度.比較兩組患者中毒後第1、3、5、7、14及15天後最大SOFA(a)的差異.結果 觀察組患者中毒後第15天最大的SOFA(a)評分為(1.80±2.05),明顯低于對照組(13.50±7.59),差異有統計學意義(P<0.05);觀察組治療後LIS(0.45±0.27)比治療前(1.15±0.34)明顯下降,也明顯低于對照組治療後(2.94±1.20),差異均有統計學意義(P<0.01).觀察組5例患者均存活,複查無訴不適,肝、腎、肺等功能複查正常.肺部CT複查1例患者左下肺後段原病竈部分未完全吸收,其他患者均未見異常.對照組8例患者有1例存活,其餘7例均死亡.觀察組患者在接受UMSC治療期間無齣現寒戰、髮熱等不良反應.結論 UMSC治療急性百草枯中毒緻肺損傷可能有一定臨床應用價值.
목적 탐토제대간충질간세포(umbilical cord mesenchymal stem cells,UMSC)치료급성백초고중독치폐손상적림상료효화안전성.방법 장2008년12월지2011년12월엄주시제12인민의원수치적13례급성백초고중독치폐손상환자분위관찰조(5례)급대조조(8례).소유환자균여상규치료,관찰조가용UMSC치료.응용구주중증의학감호의학협회(ESICM)감염상관문제공작조제정적SOFA평분체계,결합아국급성생이학화장기건강평개Ⅱ(acute physiology and chronic health evaluation,APACHEⅡ)대환자진행병정서관기관쇠갈종합평분[SOFA(a)];동시행폐손상평분(LIS)평개손상정도.비교량조환자중독후제1、3、5、7、14급15천후최대SOFA(a)적차이.결과 관찰조환자중독후제15천최대적SOFA(a)평분위(1.80±2.05),명현저우대조조(13.50±7.59),차이유통계학의의(P<0.05);관찰조치료후LIS(0.45±0.27)비치료전(1.15±0.34)명현하강,야명현저우대조조치료후(2.94±1.20),차이균유통계학의의(P<0.01).관찰조5례환자균존활,복사무소불괄,간、신、폐등공능복사정상.폐부CT복사1례환자좌하폐후단원병조부분미완전흡수,기타환자균미견이상.대조조8례환자유1례존활,기여7례균사망.관찰조환자재접수UMSC치료기간무출현한전、발열등불량반응.결론 UMSC치료급성백초고중독치폐손상가능유일정림상응용개치.
Objective To evaluate the clinical effect and safety of human umbilical cord mesenchymal stem cells (HUCMSCs) in the treatment of lung injury caused by acute paraquat poisoning.Methods Thirteen patients with lung injury caused by acute paraquat poisoning,who were admitted to Guangzhou No.12 People's Hospital from December 2008 to December 2012,were divided into HUCMSC group (n=5) and control group (n=8).All patients received conventional treatment,while the HUCMSC group was treated with HUCMSCs as an addition.Sequential Organ Failure Assessment (SOFA) system,which was created by the Infection Section of European Society of Intensive Care Medicine,and Acute Physiology and Chronic Health Evaluation Ⅱ were used to acquire the SOFA scores of patients.The lung injury was evaluated with lung injury score (LIS).The two groups were compared with respect to maximum SOFA scores at 1,3,5,7,14,and 15 days after paraquat poisoning.Results The HUCMSC group showed significantly lower maximum SOFA scores than the control group at 15 d after poisoning (1.80±2.05 vs 13.50±7.59,P<0.05) The LISs of the HUCMSC group after treatment (0.45±0.27) were significantly lower than those of the HUCMSC group before treatment (1.15±0.34)and those of the control group after treatment (2.94±1.20) (P<0.01).In the HUCMSC group,all patients survived,and they complained no discomfort and showed normal liver,kidney,and lung functions in reexamination; one patient showed incompletely absorbed shadow in the posterior segment of the left lower lobe of the lung during lung CT scan,and no abnormal findings were seen in other patients.In the control group,one patient survived,and others died.No adverse reactions,such as chill and fever,were presented in the HUCMSC group.Conclusion HUCMSCs show promise for clinical application in the treatment of lung injury caused by acute paraquat poisoning.