大剂量糖皮质激素对百草枯中毒患者血中细胞外基质成分的影响及意义

目的观察糖皮质激素对百草枯中毒患者血中细胞外基质成分的影响及其意义。方法采用病例对照研究方法，将36例患者随机分为试验组（采用大剂量甲基强地松龙冲击和长疗程）20例和对照组（常规剂量组）16例。在患者入院第1、3、10天分别采静脉血，用放射免疫法测定细胞外基质成分：层黏蛋白（LN）、透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、Ⅳ型胶原（CIV）含量。结果用药后第1天两组血中细胞外基质成分含量差异无统计学意义（P〉0．05），第3和第10天静脉血中HA、PCⅢ和CIV含量试验组明显低于与对照组（P〈0．05），而LN两组间差异仍无统计学意义；死亡率试验组明显低于对照组（P〈0．05）。结论大剂量激素可能通过减少HA、PCm和CIV等细胞外基质成分的含量，抑制百草枯致肺纤维化作用，降低其死亡率。

Study on the effects of glucocorticoid on extracellular matrix components in patients with paraquat poisoning

Objective To investigate the effect of glucocorticoid on extracellular matrix components in patients with paraquat poisoning. Methods A case - control study was designed. 36 patients admitted with a diagnosis of paraquat poisoning were divided randomly into control group （ n = 16 ） and experimental group （ n = 20 ）. The control group received conventional therapy. The experimental group received initial pulse treatment metbylp rednisolone, followed by long- term dexamethasone therapy. Venous blood were collected at 1st, 3rd and 10th days. They were measured by radioimmunoassay of extracellular matrix components： laminin （ LN）, hyaluronic acid （ HA）, Ⅲ procollagen （ PC Ⅲ） and 1V collagen （ CIV ）. Results There were no significant difference of extracellular matrix components between the two groups at 1 st （ P 〉 0. 05 ）, but the levels of HA, PC Ⅲ and CIV in experimental group were lower than control groups at 3rd and 10th days （P 〈 0. 05 ）. Meanwhile, mortality in experimental group was lower than control group. Conclusion High - dose glucocorticoid could probably inhibit paraquat - induced pulmonary fibrosis through the reduction of HA, PC Ⅲ and CIV and reduce mortality.