还原型谷胱甘肽联合乌司他丁治疗百草枯中毒患者疗效观察

Clinical observation of reduced glutathione combined with ulinastatin in the treatment of paraquat poisoning

目的探讨还原型谷胱甘肽联合乌司他丁治疗百草枯中毒患者的临床疗效。方法选取自2013年1月至2017年12月北部战区总医院收治的54例百草枯中毒患者为研究对象。根据治疗方法将其分为A组(n=24)与B组(n=30)。A组患者给予常规治疗,B组患者在A组基础上添加还原型谷胱甘肽1.8 g/次,联合注射用乌司他丁30 WU/次,均为2次/d。比较两组患者的病死率。分别于治疗后1、3 d,检测并比较两组患者血肌酐、丙氨酸氨基转移酶(ALT)、凝血酶原时间的国际标准化比值(INR)、动脉血气(PaO2)指标及血清中肿瘤坏死因子-α(TNF-α)与白细胞介素-2(IL-2)水平。结果 B组患者的病死率为76.7%(23/30),显著低于A组的95.8%(23/24),差异有统计学意义(P<0.05)。治疗后3 d,B组患者的血肌酐、ALT、INR、PaO2、TNF-α及IL-2水平均低于A组,差异均有统计学意义(P<0.05)。结论还原型谷胱甘肽联合乌司他丁治疗百草枯中毒患者,能够有效降低患者的病死率。

Objective To investigate the clinical effect of glutathione combined with ulinastatin in the treatment of paraquat poisoning.Methods A retrospective study was performed on 54 cases of patients with paraquat poisoning who were admitted from January 2013 to December 2017.Patients were divided into Group A(n=24)and Group B(n=30) according to therapeutic method.Patients in Group A were given conventional treatment,patients in Group B were added with reduced glutathione at 1.8 g/time and ulinastatin for injection at 30 WU/time on the basis of Group A,both of which were 2 times/day.The mortality of the two groups was compared.Blood creatinine,alanine aminotransferase(ALT),prothrombin time international normalized ratio(INR),arterial blood gas(PaO2)and serum levels of tumor necrosis factor-α(TNF-α)and interleukin-2(IL-2)in the two groups were detected and compared on day 1 and 3 after treatment,respectively.Results The fatality rate of Group B was 76.7%(23/30),significantly lower than that of Group A(95.8%,23/24),with statistically significant difference(P<0.05).At 3 days after treatment,serum creatinine,ALT,INR,PaO2,TNF-α and IL-2 levels in Group B were lower than those in Group A(P<0.05).Conclusion The addition of reduced glutathione combined with ulinastatin in the treatment of paraquat poisoning can effectively reduce the mortality of patients.