急性百草枯中毒长期存活患者肺损伤研究

Follow-up of the lung function in long-term survival patients with acute paraquat poisoning

目的：通过检测急性百草枯（ PQ）中毒患者在中毒后6个月的肺功能,以进一步了解PQ中毒致肺损伤的转归。方法回顾2010-09~2012-07就诊我科的50例存活至6个月的PQ中毒患者,根据临床表现及肺CT分为轻型组和重型组,在中毒后6个月时测定TLC%、RV%、RV/TLC%、TLcoSB%,经SPSS 20.0软件进行统计学分析,了解两组肺损伤的差别。结果轻型组TLC%为94.86＆#177;10.88,RV%为95.14＆#177;32.32,RV/TLC%为25.24＆#177;7.71,TLcoSB%为95.48＆#177;12.26；重型组TLC%为97.69＆#177;11.15,RV%为98.52＆#177;24.56,RV/TLC%为27.37＆#177;4.44,TLcoSB%为83.48＆#177;11.21。轻型组与重型组限制性、阻塞性通气障碍及弥散障碍异常率比较差异均无统计学意义（P〉0.05）；轻型组与重型组肺功能各项检测指标异常率比较差异均无统计学意义（P〉0.05）；轻型组与重型组TLcoSB%比较差异有统计学意义（P〈0.05）,其他指标差异均无统计学意义（P〉0.05）。结论 PQ可降低存活至6个月的部分患者肺弥散能力,对重型患者的肺泡损伤程度较轻型患者重,但两组弥散障碍异常率比较无差别。

Objective To further study the prognosis of lung injury induced by paraquat （ PQ） through the follow-up of the lung function 6 months after poisoning in long-term survival patients with acute PQ poisoning. Methods Fifty cases of PQ poisoning patients were retrospectively reviewed in our department from September 2010 to July 2012, and were divided into the mild group and the severe group according to the clinical manifestations and lung CT. TLC%, RV%, RV/TLC% and TLcoSB% were determined 6 months after PQ poisoning. The difference of lung function in the two groups was known by statistical analysis with SPSS 20. 0. Results TLC%, RV%, RV/TLC% and TLcoSB% was 94. 86 ＆#177; 10. 88, 95. 14 ＆#177; 32. 32, 25. 24 ＆#177; 7. 71 and 95. 48 ＆#177; 12. 26, respectively in mild group. TLC%, RV%, RV/TLC% and TLcoSB% was 97. 69 ＆#177; 11. 15, 98. 52 ＆#177; 24. 56, 27. 37 ＆#177; 4. 44 and 83. 48 ＆#177; 11. 21, respectively in severe group. The abnormality rate of restrictive or obstructive ventilatory disorder or diffusion disorder in mild group showed no significant difference with that in severe group（P〉0. 05）. The abnormality rate of indices of the lung function in mild group showed no significant difference with that in severe group （P〉0. 05）. TLcoSB% in mild group showed statistically difference with that in severe group（P〈0. 05）. The other indices in mild group showed no significant difference with that in severe group（P〉0. 05）. Conclusion PQ poisoning can decrease certain extent diffusion capacity in survival patients at 6 months. The alveolar damage in severe group is more serious than that in mild group. However, this difference could not make the abnormal rate of diffusion disorder in two groups show any statistical difference.