大剂量盐酸氨溴索HAMB对百草枯中毒并肺损伤患者血清MMP-9,TNF-α,IL-6水平的影响

Influence Study of High dose HAMB on MMP-9,TNF-α,IL-6 Level in Patient with PQ Poisoning and Lung Injury

目的探究大剂量盐酸氨溴索(HAMB)对百草枯(PQ)中毒并肺损伤患者血清基质金属蛋白酶-9(MMP-9)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平的影响。方法根据入院先后顺序将2015年1月至2016年12月入院的64例PQ中毒并肺损伤患者分为对照组(n=32)和研究组(n=32)。两组均予以常规治疗,研究组在此基础上加用大剂量HAMB。观察两组多器官功能障碍综合征(MODS)发生率、死亡率及死亡病例存活时间,评估两组治疗前后呼吸参数[自主呼吸频率(RR)、潮气量(VT)]及动脉氧分压(PaO_2),相关血清因子[基质金属蛋白酶-9(MMP-9)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超氧化物歧化酶(SOD)]的变化情况。结果 (1)两组MODS发生率和总死亡率对比差异无统计学意义(P>0.05),研究组较对照组治疗5d内死亡率低(P<0.05),死亡病例存活时间长(P<0.05);(2)治疗5d后,两组VT、PaO_2水平和SOD水平均较治疗前上升(P<0.05),且研究组增幅大于对照组(P<0.05),两组RR水平和MMP-9、TNF-α、IL-6水平均较治疗前下降(P<0.05),且研究组降幅大于对照组(P<0.05)。结论大剂量HAMB应用于PQ中毒并肺损伤患者效果能获得一定疗效,能发挥保护患者肺功能、降低炎性因子水平的作用。

Objective To investigate the influence of high dose？HAMB on MMP-9,TNF-α,IL-6 level in patient with PQ？poisoning and lung injury.Methods 64 cases with PQ poisoning and lung injury in our hospital from January 2015 to December2016 were divided into the control group（Jan.2015- Dec.2015,n=32）and the observation group（Jan.2016- Dec.2016,n=32）.The two groups were all given routine treatment,and the observation group was plus high dose HAMB.MODS occurrence rate,death rate,survival time of dead cases of the two groups were observed,respiration parameter（RR,VT）,PaO_2,related serum factor（MMP-9,TNF-α,IL-6,SOD）changing condition of the two groups before and after treatment were evaluated.Results（1） The difference of MODS occurrence rate,total death rate of the two groups had no statistic significance（P〈0.05）,5 d death rate of the observation group was lower than that in the control group（P〈0.05）,and survival time of dead cases was longer（P〈0.05）;（2）After 5 d,VT,PaO_2,SOD levels of the two groups were all increased（P〈0.05）,and the amplification of the observation group was larger than that in the control group（P〈0.05）,RR,MMP-9,TNF-α,IL-6 levels were all declined after treatment（P〈0.05）,and the amplification of the observation group was larger than that in the control group（P〈0.05）.Conclusion High dose HAMB has certain curative effect in patient with PQ poisoning and lung injury,it can protect lung function of patients and lower inflammatory factor level.