垂体后叶素治疗急性百草枯中毒的效果

目的：比较垂体后叶素（Pit）对百草枯中毒患者的疗效。方法收集大连医科大学附属第一医院2009年1月-2013年5月收治的百草枯中毒患者,均于基层医院给予洗胃后收入院,采用随机数字表法将34例患者分为对照组和Pit组,每组17例,Pit组在给予洗胃前即静点Pit,对照组注入等量生理盐水,两组患者均予以导泻、白陶土、甲基强的松龙、血液灌流等治疗。观察入院后第3天及第1、2、4周肺部CT的动态改变,并测定治疗前及治疗后第3天及第1、2、4周血气分析、总胆红素、谷丙转氨酶、血肌酐指标,并测定核因子-资B,基质金属蛋白酶-9指标。结果输注Pit治疗后,Pit组中毒患者肺影像学表现病变较对照组轻；Pit组第2、4周动脉氧分压指标均高于对照组（P〈0.05）；Pit组第1、2、4周总胆红素水平、谷丙转氨酶水平指标均低于对照组（P〈0.05）；Pit组第1、2周血肌酐明显低于对照组（P〈0.05）；入院第5天Pit组金属蛋白酶-9指标低于对照组（P〈0.05）,并且Pit组12、24、48 h静脉血单核细胞中NF-资B水平均低于对照组（P〈0.05）。结论 Pit能减轻百草枯所致肺损伤,取得较好的临床效果,可作为治疗百草枯中毒的辅助药物。

Therapeutic effect of pituitrin on acute lung injury of paraquat poisoning patients

Objective To investigate the protective effect of pituitrin （Pit） on the development of paraquat-induced lung injury in patients. Methods A randomized clinical trial analysis was conducted. Clinical analysis of 34 patients with paraquat poisoning admitted to the First Hospital Affiliated to Dalian Medical University from January 2009 to May 2013 were randomly divided into two groups with 17 in each： control group, Pit group. The patients in Pit group were injected with Pit through the vein, and the patients in control group were injected with the same volume of saline. All patients were treated with methylprednisolone, catharsis, white clay and hemoperfusion combined other treatment. Dy-namic change of the chest CT data of 34 patients with lung injuries induced by paraquat poisoning were analyzed retro-spectively every seven days after the administration of Pit, arterial partial pressure of oxygen, serum ALT, SCr levels and the levels of NF-κB and MMP-9 were detected respectively. Results The patients treated with Pit showed redction of pulmonary injury when compared with the patients of control group from change of the chest CT data. Arterial partial pressure of oxygen in Pit group were higher than that of control group at 2 and 4 weeks, serum ALT, Cr levels were lower than those in the control group at 2 and 4 weeks （all P〈0.05）. Compared with control group, the levels of NF-κB and MMP-9 in Pit group were lower than those in control group at five days （P〈0.05）. Conclusion These results indicate that the Pit alleviate the lung injury, and clinical results are satisfactory. Therefore, it may be a useful adju-vant in the treatment of paraquat-induced acute lung injury.