乌司他丁对急性百草枯中毒的急救效果及相关指标的影响  

The First Aid Effect of Ulinastatin in Treatment of Acute Paraquat Poisoning and Its Influence on the Relevant Indicators

作　　者：王蕾 邓伏雪 张雄 陈赵乐 王玉同 WANG Lei;DENG Fu-xue;ZHANG Xiong;CHEN Zhao-le;WANG Yu-tong(Department of Emergency,Xijing Hosipital,First Affiliated Hospital of the Air Force Medical University,Xi'an,Shaanxi,710032,China;The First Affiliated Hospital Of XI'AN JiaoTong University Department of respiration,Xi'an,Shaanxi,710061,China)

机构地区：[1]空军军医大学第一附属医院西京医院急诊科,陕西西安710032 [2]西安交通大学第一附属医院心血管内科,陕西西安710061

出　　处：《现代生物医学进展》2019年第24期4772-4775,共4页Progress in Modern Biomedicine

基　　金：陕西省自然科学基金项目(2013JM016).

摘　　要：目的:探讨乌司他丁对急性百草枯中毒的急救效果及血清白介素-18(IL-18)、基质金属蛋白酶-9(MMP-9)、高迁移率族蛋白B1(HMGB1)、生化指标、血气指标的影响。方法:选择2016年1月至2019年1月我院接诊的80例急性百草枯中毒患者,通过随机数表法分为观察组和对照组,每组40例。对照组给予常规治疗,观察组在对照组基础上联合乌司他丁治疗。比较两组血清IL-18、MMP-9、HMGB1、生化治疗、血气分析指标及28 d并发症及死亡率。结果:治疗7 d后,观察组血清IL-18、MMP-9、HMGB1、丙氨酸氨基转移酶(ALT)、肌酐(Cr)和肌酸激酶同工酶(CK-MB)、二氧化碳分压(PaCO2)均明显低于对照组,血氧分压(PaO2)明显高于对照组,差异均有统计学意义(P<0.05);观察组28 d肺功能衰竭、肾功能衰竭、中毒性心肌炎、多器官功能障碍综合征(MODS)、死亡率均明显低于对照组,差异均有统计学意义(P<0.05)。结论:乌司他丁对急性百草枯中毒的急救效果显著,且可缓解血清IL-18、MMP-9、HMGB1对组织器官所造成的炎症损伤,改善生化指标及血气指标,降低器官损伤发生率及死亡率,值得应用推广。Objective: To study the first aid effect of ulinastatin in treatment of acute paraquat poisoning and its influence on the serum interleukin-18(IL-18), matrix metalloproteinase-9(MMP-9) and high mobility group protein B1(HMGB1) levels, biochemical index and blood gas index. Methods: 80 patients of chronic renal failure who received therapy from January 2016 to January 2019 in our hospital were selected, according to random number table, they were divided into the observation group and the control group, each group had 40 cases. The control group was given routine treatment, while the observation group was treated with ulinastatin on the basis of the control group. The serum levels of IL-18, MMP-9, HMGB1, biochemical indexes, blood gas analysis, 28-day complications and mortality were compared between the two groups. Results: After treatment 7 days, the serum IL-18, MMP-9, HMGB1, alanine aminotransferase(ALT), creatinine(Cr), creatine kinase isoenzymes(CK-MB), partial pressure of carbon dioxide(PaCO2) in the observation group were significantly lower than those in the control group, and partial pressure of oxygen(PaO2) in blood was significantly higher than those in the control group, the differences were statistically significant(P<0.05);the 28-day pulmonary failure, renal failure, toxic myocarditis, multiple organ dysfunction syndrome(MODS) and mortality rate in the observation group were significantly lower than those in the control group, the differences were statistically significant(P<0.05). Conclusion: Ulinastatin has a remarkable first aid effect on acute paraquat poisoning, and can alleviate the tissues and organs inflammation damage caused by serum IL-18, MMP-9 and HMGB1,improve biochemical index and blood gas indicators, and reduce the incidence of organ injury and mortality, it’s worth popularizing.

关 键 词：乌司他丁 急性百草枯中毒 急救效果 白介素-18 基质金属蛋白酶-9 高迁移率族蛋白B1 

分 类 号：R595[医药卫生—内科学]