血必净联合甲基强的松龙治疗老年急性百草枯中毒患者的临床分析

Clinical analysis of Xuebijing Combined withMethylprednisolone in Treatment of Elderly Patients with Acute Paraquat Poisoning

目的采用血必净联合甲基强的松龙治疗老年急性百草枯中毒,分析其对患者肝肾功能及预后的影响,为治疗该病症提供方法。方法选取2015年2月-2020年2月西部战区总医院急诊科收治的105例老年急性百草枯中毒患者为研究对象,回顾性分析一般临床资料,根据患者的治疗方式进行分组,将采用甲基强的松龙治疗的患者纳入对照组(n=50),将采用血必净联合甲基强的松龙治疗的患者纳入观察组(n=55),观察并比较2组的疗效,分析2种治疗方式对患者肝肾功能、炎症因子及预后的影响。结果观察组的治疗有效率显著高于对照组(96.36%vs 80.00%,P<0.05);治疗后2组超氧化物歧化酶(SOD)均显著升高,血浆丙二醛(MDA)明显降低,且观察组治疗后SOD明显高于对照组,MDA明显低于对照组(P<0.05);治疗后2组谷丙转氨酶(ALT)和谷草转氨酶(AST)水平均显著降低,且观察组治疗后ALT和AST水平均明显低于对照组(P<0.05);治疗后2组血尿素氮(BUN)和肌酐(Cr)水平均显著降低,且观察组治疗后BUN和Cr水平均明显低于对照组(P<0.05);治疗后2组C反应蛋白(CRP)、白介素-6(IL-6)和肿瘤坏死因子(TNF-)均显著降低,且观察组治疗后CRP、IL-6和TNF-均明显低于对照组(P<0.05);2组1周生存率、2周生存率和1个月生存率差异均有统计学意义(P<0.05)。结论血必净联合甲基强的松龙治疗老年急性百草枯中毒患者,效果较佳,可有效降低炎症因子水平及百草枯对患者肝肾功能的损伤,提高患者的生存率。

Objective To explore the effect of Xuebijing combined with methylprednisolone in treatment of elderly patients with acute paraquat poisoning,and analyze the impact on the patient's liver and kidney function and prognosis,and provide clinical analysis for the treatment of the disease.Methods General data of 105 elderly patients with acute paraquat poisoning who were admitted and treated in Emergency Department of General Hospital of Western Theater Command from February 2015 to February 2020 were retrospectively analyzed.They were divided into two groups according to different treatment methods.The patients treated with methylprednisolone were included in the control group(n=50),and the ones treated with Xuebijing combined with methylprednisolone were included in the observation group(n=55).The therapeutic effects of the two groups were compared each other,and the effects of different treatments on the liver and kidney function,inflammatory factors and prognosis of patients were analyzed.Results The effective rate of the observation group was significantly higher than that of the control group(96.36%vs 80.00%,P<0.05).After treatment,the superoxide dismutase(SOD)of the two groups were significantly increased,and the plasma malondialdehyde(MDA)was decreased,and SOD of the observation group was significantly higher than that of the control group,and MDA was significantly lower than that of the control group(P<0.05);the levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)of the two groups were significantly reduced,and the ALT and AST levels of the observation group were significantly lower than those of the control group(P<0.05);the levels of the blood urea nitrogen(BUN)and creatinine(Cr)of the two groups were significantly reduced,and the levels of the BUNand Cr of the observation group were significantly lower than those of the control group(P<0.05);the levels of C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)of the two groups were significantly reduced,and the levels of CRP,IL-6,and TNF-αof the observation group were significantly lower than those of the control group(P<0.05).There were significant differences in 1-week survival rate,2-week survival rate and 1-month survival rate between the two groups(P<0.05).Conclusion Xuebijing combined with methylprednisolone has a better effect in the treatment of elderly patients with acute paraquat poisoning,which can effectively reduce inflammatory factors and paraquat damage to the liver and kidney function,and improve survival rate of patients.