摘要
目的观察百草枯中毒患者血浆核转录因子κB(NF-κB)的变化,探讨乌司他丁对炎症介质的干预作用。方法以我院2010年10月至2015年6月急诊重症监护室(EICU)收治的存活>48h的136例急性百草枯中毒患者为研究对象,随机分为常规治疗组(69例)和乌司他丁组(67例)。常规治疗组为洗胃、导泻、早期血液灌流、抗氧化、免疫抑制剂冲击及对症支持治疗;乌司他丁组在常规治疗基础上早期加用乌司他丁。以体检中心30例查体的健康者为健康对照组。于48h抽取外周血测定NF-κB的活性,白介素-6(IL-6)、肿瘤坏死因子(TNF-α)的水平,观察多脏器功能衰竭(MODS)的发生率,将两组结果进行比较。结果两组患者外周血测定NF-κB的活性,IL-6、TNF-α的水平均高于健康对照组,两组比较差异有统计学意义(P<0.05),乌司他丁组外周血测定NF-κB的活性,IL-6、TNF-α的水平低于常规治疗组,两组比较差异有统计学意义(P<0.05)。常规治疗组MODS的发生率为56.65%,乌司他丁组MODS的发生率为34.33%,两组比较差异有统计学意义(χ2=5.891,P=0.031)。结论乌司他丁能够有效地抑制急性百草枯中毒中毒后炎症反应,保护重要脏器功能,降低死亡率。
Objective To investigate the changes of the expression of plasma nuclear transcription factor（NF-κB）of the Paraquat（PQ）poisoning patients,to explore the intervention effect of ulinastatin on inflammatory mediators.Methods 136 patients with acute PQ poisoning who alive more than 48 hours from October 2010 to June 2015 in EICU of our hospital were as research objects,they were randomly assigned to be treated with conventional therapy lonely（control group）or in combination with ulinastatin（treatment group）.conventional therapy consist of gastric lavage,catharsis,early blood perfusion,anti-oxidation,immune inhibitors and support therapy.35 cases of normal physical examination in physical examination center（MES）is healthy control group.The activity of the nuclear transcription factor（NF-κB）,the levels of serum interleukin 6（IL-6）and tumor necrosis factor（TNF alpha）were examined at 48 hto observe the incidence of multiple organ dysfunction syndrome（MODS）and to compare the results.Results The NF-κB activity,serum interleukin 6（IL-6）and tumor necrosis factor（TNF alpha）levels of the two groups of patients were higher than those of healthy control group,with statistical significance（P〈0.05）.The NF-κB activity,serum interleukin 6（IL-6）and tumor necrosis factor（TNF alpha）levels of the treatment group were lower than those of the control group,with statistical significance（P〈0.05）.Therate of the incidence of MODS of the control group is 53.78%,higher than 34.69% of the treatment group,with statistical significance（χ2=5.905,P=0.031）.Conclusion Ulinastatin can effectively inhibit inflammatory mediator after acute paraquat poisoning,protect the function of important visceras,reduce the mortality.
出处
《滨州医学院学报》
2016年第1期33-35,共3页
Journal of Binzhou Medical University
