GSH联合HP治疗急性百草枯中毒的效果观察
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摘要
目的观察还原型谷胱甘肽(GSH)联合血液灌流(HP)治疗急性百草枯中毒的效果。方法将60例急性百草枯中毒患者随机分为A组(30)与B组(30),B组采用HP治疗,A组采用GSH联合HP治疗,比较两组的疗效;剔除治疗过程中死亡患者后,统计存活患者治疗前后炎症因子、氧化应激指标、血尿淀粉酶、血清脂肪酶水平及肝功能指标的变化。结果 A组治疗有效率(56.67%)高于B组(30.00%)(P <0.05),治疗后白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)、超氧化物歧化酶(SOD)、血尿淀粉酶、血清脂肪酶、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TB)、γ-谷氨酰转肽酶(GGT)水平显著低于B组(P <0.05),白细胞介素-10(IL-10)、谷胱甘肽过氧化物酶(GSH-Px)、白蛋白(ALB)水平显著高于B组(P <0.05)。结论应用GSH联合HP治疗,可显著减轻急性百草枯中毒患者机体氧化应激损伤及炎症反应,保护患者胰肝功能,提高疗效。
Objective To observe the effects of reduced glutathione(GSH) combined with hemoperfusion(HP) in the treatment of acute paraquat poisoning. Methods A total of 60 patients with acute paraquat poisoning were randomly divided into group A and group B(n =30, respect ively). Group B was treated with HP and group A with GSH combined with HP. The effects were compared between the two groups. The changes in the inflammatory factors, oxidative stress index, hematuria amylase, serum lipase levels and liver function before and after the treatment in surviving patients, i.e., excluding those who died during the treatment. Results The overall response rate(ORR)(56.67%) in group A was higher than that(30.00%) in group B(P < 0.05). The post-treatment levels of interleukin 6(IL-6), tumor necrosis factor-α(TNF-α), malondialdehyde(MDA), superoxide dismutase(SOD), hematuria amylase, serum lipase, alanine transaminase(ALT), aspertate aminotransferase(AST), total bilirubin(TB), γ-glutamyltranspeptidase(GGT) were significantly lower than those in group B, but the post-treatment levels of interleukin 10(IL-10), glutathione peroxidase(GSH-Px) and albumin(ALB) were significantly higher than those in group B(P < 0.05). Conclusion GSH combined with HP can significantly alleviate the oxidative stress injury and inflammatory response in patients with acute paraquat poisoning, and can protect the pancreas and liver functions and improve the curative effects.
Objective To observe the effects of reduced glutathione(GSH) combined with hemoperfusion(HP) in the treatment of acute paraquat poisoning. Methods A total of 60 patients with acute paraquat poisoning were randomly divided into group A and group B(n =30, respect ively). Group B was treated with HP and group A with GSH combined with HP. The effects were compared between the two groups. The changes in the inflammatory factors, oxidative stress index, hematuria amylase, serum lipase levels and liver function before and after the treatment in surviving patients, i.e., excluding those who died during the treatment. Results The overall response rate(ORR)(56.67%) in group A was higher than that(30.00%) in group B(P < 0.05). The post-treatment levels of interleukin 6(IL-6), tumor necrosis factor-α(TNF-α), malondialdehyde(MDA), superoxide dismutase(SOD), hematuria amylase, serum lipase, alanine transaminase(ALT), aspertate aminotransferase(AST), total bilirubin(TB), γ-glutamyltranspeptidase(GGT) were significantly lower than those in group B, but the post-treatment levels of interleukin 10(IL-10), glutathione peroxidase(GSH-Px) and albumin(ALB) were significantly higher than those in group B(P < 0.05). Conclusion GSH combined with HP can significantly alleviate the oxidative stress injury and inflammatory response in patients with acute paraquat poisoning, and can protect the pancreas and liver functions and improve the curative effects.
引文
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[12]朱保月,苏晓阳,李敬,等.还原型谷胱甘肽对有机磷农药中毒患者血清IL-18水平的影响[J].河北医药,2014, 36(5):713-714.
[2]邱俏檬,刘瑶,宋芹,等.血液灌流对急性百草枯中毒兔氧化应激和基质金属蛋白酶及其抑制物的影响[J].中华劳动卫生职业病杂志, 2012, 30(2):89-96.
[3]辛光大,周广宇.还原型谷胱甘肽治疗老年急性肾损伤患者的疗效[J].中国老年学, 2014, 34(5):1354-1355.
[4]黄家淦,阳小灵,刘先发,等.还原型谷胱甘肽对急性百草枯中毒治疗作用的实验研究[J].赣南医学院学报, 2015, 35(4):522-525.
[5]黄大鹏,李倩.急性百草枯中毒临床治疗现状及研究进展[J].安徽医药, 2018, 22(1):29-32.
[6]王鸾,赵敏.急性百草枯中毒机制及治疗进展[J].医学综述, 2017,23(14):2790-2793.
[7]黄昌保,孙兆瑞,杨志洲,等.肝脏酶谱变化对急性百草枯中毒患者的预后作用的研究[J].临床急诊杂志, 2016, 17(11):823-828.
[8]张炜,刘红梅,任艺,等.急性百草枯中毒致药物性肝病影响因素的分析[J].临床急诊杂志, 2014, 15(7):387-389.
[9]肖友文,潘红霞,张帆,等.血液灌流联合血液透析救治急性百草枯中毒患者的临床疗效分析[J].临床肾脏病杂志, 2016, 16(11):669-672.
[10]聂亚冬,张重阳,刘新.血液灌流联合血液滤过治疗急性百草枯中毒患者的临床分析[J].山西医药杂志,2015, 44(6):624-626.
[11]彭志华.还原型谷胱甘肽对重症急性胰腺炎肝损害的保护作用和机制探讨[J].现代中西医结合杂志, 2015, 24(8):805-807.
[12]朱保月,苏晓阳,李敬,等.还原型谷胱甘肽对有机磷农药中毒患者血清IL-18水平的影响[J].河北医药,2014, 36(5):713-714.