CAJ | 학술논문

目的探讨序贯性优化治疗急性百草枯中毒患者不同时间段炎性因子水平的变化. 方法将58例急性百草枯中毒患者随机分为治疗组与对照组,对照组给予环磷酰胺、大剂量肾上腺糖皮质激素等综合治疗,治疗组加用序贯净化治疗. 2组均以住院期间临床死亡作为观察终点,分为存活组和死亡组. 所有入选者在入院后6 h、24 h、72 h内抽取静脉血3 mL,检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、IL-6 、IL-10及C反应蛋白( CRP)水平,分析治疗组各炎性因子水平、服毒剂量与预后的相关性. 结果治疗组和对照组入院后6 h血清各炎性因子水平比较差异无统计学意义( P均>0.05) ;治疗组和对照组入院后24 h血清各炎性因子水平高于6 h(P均<0.05),入院后72 h高于6 h、24 h(P均<0.05),对照组入院后24 h、72 h血清各炎性因子水平明显高于治疗组(P均<0.05). 治疗组和对照组中死亡组24 h、72 h血清各炎性因子水平均明显高于存活组(P均<0.05). 治疗组血清TNF-α、IL-1、IL-6 、IL-10水平与病死率呈正相关. 结论尽早实施序贯性优化治疗救治急性百草枯中毒,可降低患者血清炎性因子TNF-α、IL-1、IL-6、IL-10、CRP水平,减轻脏器损伤,降低病死率,改善患者预后.
목적 탐토서관성우화치료급성백초고중독환자불동시간단염성인자수평적변화. 방법 장58례급성백초고중독환자수궤분위치료조여대조조,대조조급여배린선알、대제량신상선당피질격소등종합치료,치료조가용서관정화치료. 2조균이주원기간림상사망작위관찰종점,분위존활조화사망조. 소유입선자재입원후6 h、24 h、72 h내추취정맥혈3 mL,검측혈청종류배사인자-α(TNF-α)、백세포개소-1(IL-1)、IL-6 、IL-10급C반응단백( CRP)수평,분석치료조각염성인자수평、복독제량여예후적상관성. 결과 치료조화대조조입원후6 h혈청각염성인자수평비교차이무통계학의의( P균>0.05) ;치료조화대조조입원후24 h혈청각염성인자수평고우6 h(P균<0.05),입원후72 h고우6 h、24 h(P균<0.05),대조조입원후24 h、72 h혈청각염성인자수평명현고우치료조(P균<0.05). 치료조화대조조중사망조24 h、72 h혈청각염성인자수평균명현고우존활조(P균<0.05). 치료조혈청TNF-α、IL-1、IL-6 、IL-10수평여병사솔정정상관. 결론 진조실시서관성우화치료구치급성백초고중독,가강저환자혈청염성인자TNF-α、IL-1、IL-6、IL-10、CRP수평,감경장기손상,강저병사솔,개선환자예후.
Objective:It is to explore the effects of sequential optimization of treatment on inflammatory factors at differ-ent time stage in the patients with acute poisoning of Paraquat ( APP) .Methods 58 patients with APP were randomly divided into treatment group and control group.The control group was treated with comprehensive therapy such as cyclophosphamide and high dose adrenal cortex hormone.The treatment group was added with sequential purification treatment.In the two groups, the clinical death was observed as the end point, they were divided into survival group and death group.All the pa-tients' 3 mL vein blood was gotten in 6 h, 24 h, 72 h after hospitalization to determine the levels of TNF-α, IL-1, IL-6, IL-10 and CRP, the correlation of inflammatory factors, dosage of the poison with prognosis.Results There was no signifi-cant difference in the serum levels of inflammatory factors between control group and treatment group at 6 h after admission(P>0.05), the levels at 24 h after admission were higher than that at 6 h, the levels at 72 h were higher than that at 6 h and 24 h in treatment group and control group (all P<0.05).The levels at 24 h and 72 h after admission in the control group were higher than that in the treatment group (all P<0.05).The levels at 24 h and 72 h after admission in each death group were higher than that in each survival group in both treatment group and control group (all P<0.05).The levels of TNF-α, IL-1, IL-6, IL-10 were positively correlated with mortality in treatment group.Conclusion The implementation of sequential optimization treatment for APP as soon as possible, can inhibit inflammatory factors of blood serum TNF-α, IL-1, IL-6, IL-10 expression, reduce organ injury, reduce pulmonary fibrosis, decrease mortality, improve the prognosis of the patients.