环磷酰胺对百草枯中毒致急性肺损伤的疗效及安全性分析

Effectiveness and Safety of Cyclophosphamide for Treating Patients with Paraquat-induced Acute Lung Injury

目的探讨大剂量环磷酰胺治疗百草枯中毒所致急性肺纤维化的疗效与安全性。方法回顾性分析我院2007年3月—2012年3月收治的百草枯中毒患者79例,其中常规治疗43例(对照组),常规治疗联合大剂量环磷酰胺15 mg/kg治疗36例(治疗组)。对比分析两组患者的临床特征和实验室检查指标、4周后死亡率、死于肺纤维化的比例及肺纤维化、多器官功能衰竭、并发症发生率。结果两组患者的临床特征和实验室检查指标间差异无统计学意义(P>0.05)。治疗组4周后死亡率、死于肺纤维化的比例和多器官功能衰竭的发生率均低于对照组,差异有统计学意义(P<0.05)。两组肺纤维化和消化道出血发生率间差异无统计学意义(P>0.05)。结论在常规治疗的基础上联合环磷酰胺治疗百草枯中毒可以提高中毒患者的生存率,而且安全性和耐受性良好。

Objective To evaluate the effectiveness and safety of combined treatment with cyclophosphamide for pa- raquat- induced acute pulmonary fibrosis. Methods We retrospectively reviewed 79 paraquat poisoning cases treated in our hospital between March 2007 and March 2012. Among them, 43 cases （control group） were treated with conventional therapy, and 36 cases （study group ） with combination of cyelophosphamide （15 mg/kg）. Clinical characteristics, laboratory test re- sults, 4 - week fatality rate, the ratio of died of pulmonary fibrosis, and the incidences of pulmonary fibrosis, muhiple organ failure, and severe complications were compared between the two groups. Results No differences were observed between the two groups in clinical characteristics and laboratory test results （ P 〉 0.05 ）. The 4 - week fatality rate, mortality of pulmonary fibrosis, and incidence of multiple organ failure in the study group were significantly lower than that in the control group （ P 〈 0. 05 ）. Conclusion Conventional treatment combined with cyclophosphamide may improve survival rate in patients with pa- raquat poisoning and has higher safety and tolerance.