大剂量氨溴索联合甲强龙早期应用对百草枯中毒肺纤维化的疗效

Effects of early application of ambroxol combined with methylprednisolone on paraquat poisoning pulmonary fibrosis

目的研究大剂量氨溴索联合甲强龙早期应用对百草枯中毒患者肺纤维化的疗效。方法选取安徽医科大学第二附属医院98例百草枯中毒患者,按入院日期随机分成甲强龙组(对照组)及氨溴索联合甲强龙组(观察组),每组49例,观察两组患者的存活率、肺纤维化发生率和肺纤维化程度。结果观察组和对照组在各时间点的存活率差异无统计学意义(P>0.05),观察组与对照组在第3天的肺纤维化发生率差异无统计学意义(P>0.05),第4周时,观察组肺纤维化发生率显著低于对照组(P<0.05),观察组在第1周比第3天的肺纤维化程度增加(P<0.05),而对照组各时间点比前一时间点的肺纤维化程度增加(P<0.05),在第2周及第4周时,观察组肺纤维化程度低于对照组(P<0.05)。结论大剂量氨溴索联合甲强龙早期应用对百草枯中毒患者的存活率不能显著提高,但使百草枯中毒导致的肺纤维化发生率及肺纤维化程度均有所下降,可用于临床。

Objective To study the effects of high-dose ambroxol combined with methylprednisolone on pulmonary fibrosis in patients with early curative effect of paraquat poisoning. Methods Ninety-eight cases of paraquat poisoning patients admitted to the Second Affiliated Hospitalwere selected and randomly divided into two groups according to the date of admission,namely,a strong dragon group alone（control group） and ambroxol combined with a strong dragon group（observation group）,with 49 patients in each group,then the survival rate,the incidence of pulmonary fibrosis and the degree of pulmonary fibrosis in the two groupswere observed. Results The survival rate of the observation group and the control group at each time point was not statistically significant,andthe incidence of pulmonary fibrosis in the observation group and the control group on the third daywas not statistically significant. In the fourth week,the incidence rate of pulmonary fibrosis in the observation group was significantly lower than that in the control group（P〈0. 05）. In the observation group,the degree of pulmonary fibrosis increased in the first week compared to that of the third day（P〈0. 05）. The degree of pulmonary fibrosis in the control group was increased at each time point compared with the previous time（P〈0. 05）. The degree of pulmonary fibrosis in the observation group was lower than that in the control group in the secondand fourth week（P〈0. 05）. Conclusion The survival rate of patients is not significantly increased by the application of large dose of ambroxol hydrochloride combined with methylprednisolone in early stage of paraquat poisoning,but the occurrence rate and the degree of pulmonary fibrosis resulted from paraquat poisoning is decreased,thus it can be used for clinicaltreatment.