血必净联合甲基强地松龙救治百草枯中毒146例疗效分析  

Xuebijing combined with corticosteroid injection treating paraquat poisoning analysis of 146 cases

作　　者：张国秀[1] 王玉华[1] 胡莹莹[1] 

机构地区：[1]河南科技大学第一附属医院急诊科,洛阳471003

出　　处：《国际中医中药杂志》2011年第1期8-11,共4页International Journal of Traditional Chinese Medicine

摘　　要：目的 采用回归性分析评价血必净注射液联合糖皮质激素救治百草枯中毒的临床疗效与安全性.方法 按随机数字表法将我院急诊科收治的146例百草枯中毒患者随机分为两组,激素治疗组50例给予甲基强地松龙,500 mg/次,2次/d,3 d后开始逐渐减量;血必净组96例在激素治疗基础上加用血必净注射液300～400 ml/d.观察患者临床变化,于治疗前及治疗后第3、7、14天分别检测各组血中白细胞计数（WBC）、中性粒细胞（N）、C-反应蛋白（CRP）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（STB）、血肌酐（SCr）水平,并每天检测患者动脉血氧分压（PaO2）、自第一天起每隔3 d拍1次胸部CT（1、4、8、12、30天）了解肺部情况.同时通过2个月后随访或患者复查比较两组的生存率等.结果 生化指标检测（WBC、N、CRP、PaO2）激素治疗组14 d时[分别为（16.49±4.30）、（84.22±21.07）、（24.58±7.06）、（83.20±22.95）]较3 d时[分别为（19.21±5.34）、（85.04±12.33）、（27.98±6.51）、（73.42±11.43）]有所改善,但差异无统计学意义（P〉0.05）.血必净组14 d后[分别为（9.16±3.23）、（70.48±10.79）、（17.48±4.7）、（95.04±11.93）]较3 d时[分另为（16.96±9.95）、（84.82±9.34）、（27.34±10.03）、（89.12±9.47）]显著改善,差异有统计学意义（P〈0.05）.治疗14 d后,血必净治疗组与激素治疗组各检测指标比较,差异有统计学意义（P〈0.05）.②激素治疗组2月后生存率为32%,血必净组生存率为67.71%.两组比较,差异有统计学意义（x2=9.588,P〈0.05）.③与激素治疗组相比,血必净组胸片显示肺部病变有轻微改善.结论 血必净注射液联合甲基强地松龙对百草枯中毒具有良好的治疗作用.Objective To evaluate the efficacy and safety of Xuebijing combined with corticosteroid injection treating paraquat poisoning with regression analysis. Methods 146 patients of paraquat poisoning in 3 years were divided into two groups： control group and therapeutic group. 50 patients in the control group were treated with Methylprednisolone, while 96 patients in the therapeutic group were treated with Xuebijing injection （300～400 ml/d, intravenous drip） and Methylprednisolone. The patients＇ clinical symptoms, signs and the levels of white blood cell （WBC）, Neutrophils （N）, C-reactive protein （CRP）, glutamic-pyruvic transaminase （ALT）, aspartate aminotransferase （AST）, serum creatinine （Scr） and arterial partial pressure of oxygen were collected. And patients did chest CT examinations every three days. All the data were compared between the two groups. Results ① The biochemical indicators of the control group in the 14th day [WBC,N,CRP, and PaO2 is （16.49±4.30）, （84.22±21.07）, （24.58±7.06）, and （83.20±22.95） respectively]were better than those in the third day[WBC, N, CRP, and PaO2 is （19.21 ±5.34）, （85.04± 12.33）, （27.98±6.51）, and （73.42±11.43）respectively], but there was not significant difference between them（P〉0.05）. While the biochemical indicators of the therapeutic group in the 14th day [WBC,N, CRP, and PaO2 is （9.16 ± 3.23 ）, （70.48 ± 10.79）, （ 17.48 ± 4.7）, and （95.04± 11.93） respectively] were much better than those in the third day [WBC,N,CRP, and PaO2 is （16.96±9.95）,（84.82±9.34）, （27.34± 10.03）, and （89.12±9.47） respectively], and there was significant difference between them（ P〈 0.05 ）. ② The survival rate in the control group was 32% comparing to 67.71% in the therapeutic group, showing significant difference between the two group （x2=9.588, P〈0.05） . ③ The patients＇ chest CT examinations in the therapeutic group were better than those in the control group. Con

关 键 词：百草枯 中毒 血必净 甲基强地松龙 中西医 

分 类 号：R595.4[医药卫生—内科学]