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环孢素联合甲泼尼龙琥珀酸钠冲击治疗对急性百草枯中毒患者肺纤维化的影响
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| 篇名： | 环孢素联合甲泼尼龙琥珀酸钠冲击治疗对急性百草枯中毒患者肺纤维化的影响 |
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| 摘要： | 目的：探讨环孢素联合甲泼尼龙琥珀酸钠冲击治疗对急性百草枯中毒患者肺纤维化的影响。方法：采用回顾性研究法，选取39例急性百草枯中毒患者，按照治疗方案分为对照组（18例）和观察组（21例）。对照组患者给予阻断毒物吸收、促进毒物排出以及对症支持处理，观察组患者在此基础上给予注射用甲泼尼龙琥珀酸钠1 000 mg，ivgtt，qd+环孢素注射液5 mg/kg，ivgtt，qd冲击治疗，甲泼尼龙琥珀酸钠于第4天逐渐减量，均在7 d后停用。观察两组患者血清中透明质酸（HA）、层粘连蛋白（LN）、Ⅳ型胶原蛋白（CⅣ）、Ⅲ型前胶原（PCⅢ）、基质金属蛋白酶（MMP）9及血清基质金属蛋白酶抑制物（TIMP）1等指标，行肺部高分辨率CT（HRCT）评分，并记录不良反应发生情况。结果：观察组患者治疗后第3、5天的HA和PCⅢ明显低于对照组，治疗后第7、14天的HA、CⅣ和PCⅢ明显低于对照组，治疗后第3、5、7天的MMP-9水平明显低于对照组，差异均有统计学意义（P＜0.05）。两组患者治疗后2周血清TIMP-1水平和HRCT评分逐步升高，但观察组患者明显低于对照组，差异均有统计学意义（P＜0.05）。两组患者治疗期间均未见明显不良反应发生。结论：环孢素联合甲泼尼龙琥珀酸钠冲击治疗对急性百草枯中毒患者肺纤维化进程有明显缓解作用，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To discuss the effects of cyclosporine combined with methylprednisolone sodium succinate pulse therapy on pulmonary fibrosis in patients with acute paraquat poisoning. METHODS： By retrospective study method， 39 cases of acute paraquat poisoning were divided into observation group （21 cases） and control group （18 cases） according to therapy plan. Control group received blocking the absorption of poison， promoting the discharge of poison’supportive and symptomatic treatment； observation group was additionally given Methylprednisolone sodium succinate for injection 1 000 mg，ivgtt， qd+Cyclosporin injection 5 mg/kg，ivgtt，qd， pulse therapy； the dose of dethylprednisolone sodium succinate decreased gradually since forth day and it had been stopped after 7 days. The serum levels of hyaluronic acid （HA）， laminin （LN）， Ⅳ collagen （CⅣ）， Ⅲ procollagen （PCⅢ）， matrix metalloproteinase （MMP）9 and serum matrix metalloproteinase inhibitors （TIMP）1， lung HRCT score were observed in 2 groups， and the occurrence of ADR was recorded. RESULTS： HA and PCⅢ of observation group on 3rd and 5th day of treatment were significantly lower than those of control group， and HA， CⅣ and PCⅢ on 7th and 14th day of treatment were significantly lower than those of control group， levels of MMP-9 in observation group on 3rd， 5th， 7th day of treatment were significantly lower than those of control group， with statistical significance （P＜0.05）. Levels of TIMP-1 and HRCT score in 2 groups increased gradually 2 weeks after treatment， and that of observation group was significantly lower than that of control group， with statistical significance （P＜0.05）. No obvious ADR was found in 2 groups during treatment. CONCLUSIONS： Cyclosporin combined with methylprednisolone sodium succinate pulse therapy can significantly relieve pulmonary fibrosis in patients with acute paraquat poisoning with good safety. |
| 期刊： | 2016年第27卷第23期 |
| 作者： | 付显芬，罗真春 |
| AUTHORS： | FU Xianfen，LUO Zhenchun |
| 关键字： | 甲泼尼龙琥珀酸钠；环孢素；百草枯；肺纤维化 |
| KEYWORDS： | Methylprednisolone sodium succinate； Cyclosporin； Paraquat； Pulmonary fibrosis |
| 阅读数： | 439 次 |
| 本月下载数： | 3 次 |
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