盐酸氨溴索对百草枯中毒患者血清肿瘤坏死因子-α和白细胞介素-6水平的影响

Effects of high dose ambroxol hydrochloride on the levels of serum TNF-α and IL-6 in patients of acute paraquat poisoning

目的探讨急性百草枯中毒肺损伤患者的血清肿瘤坏死因子(TNF)-α与白细胞介素(IL)-6水平和大剂量盐酸氨溴索(HAMB)干预的影响。方法将31例急性百草枯中毒肺损伤患者分为HAMB治疗组16例和常规治疗组15例,采用酶联免疫吸附法检测2组患者治疗前、治疗后3d以及12例健康对照组的TNF-α和IL-6的水平,并予对比;并进行治疗前、后肺损伤评分(LIS)。结果急性百草枯中毒肺损伤患者血清TNF-α和IL-6的水平较健康对照组显著增高(P<0.01);2组患者治疗后血清TNF-α和IL-6的水平以及LIS均较治疗前有显著改善(P<0.01),但HAMB治疗组较常规治疗组改善更明显(P<0.05)。结论急性百草枯中毒肺损伤患者存在炎性细胞因子水平的高表达,炎症反应参与了急性百草枯中毒肺损伤的发病过程;HAMB的干预能一定程度地抑制促炎因子的水平,对减轻或延缓中毒性肺损伤有积极的保护作用。

Objective To explore the levels of serum cytokine in acute paraquat poisoning patients with pulmonary damage and the effects of intervention with high dose of ambroxol hydrochloride（HAMB）.Methods 31 cases of acute paraquat poisoning patients with pulmonary damage were divided into HAMB therapy group （HAMB group,16 cases） and conventional therapy group （15 cases）.Serum TNF-α and IL-6 levels were measured by ELISA in 2 groups before and 3 days after the therapy and then compared with the results of 12 cases of healthy volunteers.Lung injury score （LIS） was evaluated in 2 groups before and after the therapy.Results TNF-α and IL-6 levels in the patients were significantly higher than those in healthy volunteers （P0.01）.After the treatment,TNF-α,IL-6 and LIS were significantly improved both in HAMB and conventional therapy group （P0.01）,but the effects in HAMB were more obvious than those in the conventional therapy group （P0.05）.Conclusion Acute paraquat poisoning patients with pulmonary damage were characterized as high serum leves of TNF-α and IL-6,and as inflammatory reaction was involved in the process of toxic pulmonary damage.HAMB therapy may play an role in improving the levels of TNF-α,IL-6 and pulmonary damage.