依达拉奉治疗百草枯中毒的临床研究  

Clinical study of edaravone on treating patients with paraquat poisoning

作　　者：李俊稷 李晓萍[1] 邓朝霞[1] 刘明华[1] 

机构地区：[1]第三军医大学西南医院急救部,重庆400038

出　　处：《重庆医学》2014年第34期4631-4633,4636,共4页Chongqing medicine

摘　　要：目的观察依达拉奉是否对百草枯中毒患者具有器官保护和肺纤维化抑制作用,为临床治疗百草枯中毒提供理论依据和方法。方法搜集2010年6月至2013年5月该院收治的百草枯中毒患者52例,分为常规治疗+安慰剂治疗组(A组,n=24)和常规治疗+依达拉奉组(B组,n=28)。ELISA检测患者入院后24h、第3天和第7天的血清炎症因子IL-6和TNF-α的表达。评价并记录在同样时间点的神经、心脏、肝脏、肾脏和消化系统损伤以及患者第7、14、30天后肺部特征改变和生存率变化。结果 B组在治疗第7天和第14天内表现出较强的抗肺纤维化和降低患者病死率作用。1个月的随访发现,依达拉奉对肺纤维化概率和患者的生存率并无明显提高(P>0.05)。依达拉奉能降低百草枯引起的IL-6和TNF-α的增加,依达拉奉能保护百草枯中毒患者的肝肾器官受损,并降低心血管并发症的产生,但对消化道损伤引起的便血和呼吸系统综合征无明显保护作用。结论依达拉奉对百草枯引起的肝脏和肾脏损伤有保护作用;能明显延缓肺纤维化的发生,延长患者生存时间。但对肺纤维化概率和患者的生存率并无明显提高。Objective To evaluate whether edaravone can inhibit pulmonary fibrosis when treating patients with paraquat poi-soning and to provide theories and ways for clinical treatment.Methods Fifty-two patients from southwest hospital were selected from June 2010 to May 2013.These patients were voluntarily divided into 2 groups,one of which was treated with placebo plus reg-ular therapy （A group,n=24）while the other was treated with edaravone and regular therapy（B group,n=28）.ELISA was applied to detect IL-6 and TNF-alpha expression in serum of patients at 24 hours,3rd day,7th day after hospitalization.Toxic damages to organs such as lung,liver,kidney,as well as to cardiovascular,nervous and digestive system were examined,recorded and evaluated at the same time point.The changes of lung characteristics and of the survival rate were evaluated and recorded at 7th,14th and 30th days after hospitalization.Results Although,within 7 and 14 days′treatment,edaravone group showed a strong anti-pulmona-ry fibrosis.After a month following-up,survival rate and pulmonary fibrosis rate of edaravone group had no significant difference in non-B group （P〉0.05）.The increase of IL-6 and TNF-α,and the liver and kidney damage reduced by edaravone,as well as cardio-vascular complications.However,respiratory complications and hematochezia caused by gastrointestinal damage didn′t respond to the treatment of edaravone.Conclusion Edaravone could protect most organs from inflammation and postpone the onset of pulmo-nary fibrosis and increase survival time of patients.But edaravone could not improve the rate of pulmonary fibrosis and survival.

关 键 词：百草枯 中毒 安替比林 依达拉奉 肺纤维化 

分 类 号：R595.4[医药卫生—内科学]