乌司他丁联合乙酰半胱氨酸对急性百草枯中毒患者炎性细胞因子、肺纤维化相关因子的影响  

Effects of Ulinastatin Combined with Acetylcysteine on Inflammatory Cytokines and Pulmonary Fibrosis Related Factors in Patients with Acute Paraquat Poisoning

作　　者：常振东[1] 杨莹[1] 黄凯歌 CHANG Zhen-dong;YANG Ying;HUANG Kai-ge(Emergency Department,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院急诊科,南阳473000

出　　处：《中国合理用药探索》2025年第1期77-83,共7页Chinese Journal of Rational Drug Use

基　　金：2021和2022年度河南省医学科技攻关计划省部共建项目(SBGJ202102221)。

摘　　要：目的:探讨乌司他丁联合乙酰半胱氨酸对急性百草枯中毒(APP)患者炎性细胞因子、肺纤维化相关因子的影响。方法:回顾性选取2021年1月~2023年12月期间于某院治疗的96例APP患者作为研究对象,根据治疗方式分为对照组和观察组,每组48例。两组患者均给予洗胃、血液净化、抗炎、抗氧化等基础治疗,对照组患者在基础治疗基础上给予注射用乌司他丁治疗,观察组患者在对照组治疗基础上给予乙酰半胱氨酸泡腾片治疗,两组均治疗14天。比较两组患者临床指标[机械通气、重症监护病房(ICU)住院时间、Ⅰ型呼吸衰竭]、血气分析指标[氧合指数(OI)、动脉血氧分压(PaO2)]、炎症因子[肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)、白介素-6(IL-6)]、肺纤维化相关因子[基质金属蛋白酶-9(MMP-9)、转化生长因子-β1(TGF-β1)]、肝肾功能指标[谷丙转氨酶(ALT)、血肌酐(SCr)]及治疗14天后存活情况。结果:治疗后,观察组患者机械通气、Ⅰ型呼吸衰竭发生率及ICU住院时间均低于对照组(P<0.05)。两组患者OI、PaO2均升高,且观察组高于对照组(P<0.05);血清TNF-α、hs-CRP、IL-6、MMP-9和TGF-β1水平均降低,且观察组低于对照组(P<0.05);血清ALT和SCr水平均降低,但两组比较无统计学差异(P>0.05)。观察组患者治疗14天后存活率(62.50%)高于对照组(41.67%,P<0.05)。结论:乌司他丁联合乙酰半胱氨酸可显著改善患者临床指标,缓解炎症反应,抑制肺纤维化相关因子生成,且不增加肝肾损伤。Objective:To investigate the effects of ulinastatin combined with acetylcysteine on inflammatory cytokines and pulmonary fibrosis related factors in patients with acute paraquat poisoning(APP).Methods:A total of 96 patients with APP,treated in a hospital from January 2021 to December 2023,were retrospectively selected and divided into the control group and the observation group according to different treatment methods,with 48 patients in each group.Both groups were given standard treatments,including gastric lavage,blood purification,anti-inflammatory,antioxidant.The control group was given ulinastatin for injection in addition to standard treatment,while the observation group was given acetylcysteine effervescent tablets in addition to the treatment provided to the control group.Both groups were treated for 14 days.Clinical indicators[mechanical ventilation,length of stay in the intensive care unit(ICU)and type I respiratory failure],blood gas analysis indicators[oxygenation index(OI)and arterial partial pressure of oxygen(PaO2)],inflammatory factors[tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP),and interleukin-6(IL-6)],pulmonary fibrosis related factors[matrix metalloproteinase-9(MMP-9)and transforming growth factor-β1(TGF-β1)],liver and kidney function indicators[alanine aminotransferase(ALT)and serum creatinine(SCr)]and survival after 14 days of treatment were compared between the two groups.Results:After treatment,the incidence of mechanical ventilation,type I respiratory failure,and length of stay in ICU in the observation group were significantly lower than those in the control group(P<0.05).OI and PaO2 were increased in both groups,with the observation group showing significant higher values than the control group(P<0.05).Serum levels of TNF-α,hs-CRP,IL-6,MMP-9 and TGF-β1 were decreased in both groups,with the observation group exhibiting significantly lower levels than the control group(P<0.05).Both serum levels of ALT and SCr were decreased in both groups,however,no stat

关 键 词：乌司他丁 乙酰半胱氨酸 急性百草枯中毒 炎性细胞因子 肺纤维化相关因子 

分 类 号：R595.4[医药卫生—内科学]