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目的探讨甲硫酸新斯的明对百草枯中毒的治疗作用。方法回顾性分析2014年7月至2016年6月在我院治疗的百草枯中毒患者43例,根据患者是否加用新斯的明治疗分为常规治疗组(n=21)及新斯的明组(n=22)。对比两组患者入院时,入院后48 h的血清TNF-α、IL-6、IL-10水平及急性生理学及慢性健康状况(APACHEⅡ)评分、肺损伤评分(lung injury score,LIS);对比两组患者3个月内病死率。结果两组患者入院当天血清TNF-α、IL-6、IL-10水平相近,差异无统计学意义(P>0.05);治疗2 d后,新斯的明组血清TNF-α、IL-6水平明显低于常规治疗组(P<0.01)。两组患者入院当天APACHEⅡ评分、LIS评分相近,差异无统计学意义(P>0.05);分别治疗2 d后,新斯的明组APACHEⅡ评分、LIS评分低于常规治疗组(P<0.05)。两组患者在3 d内病死率差异无统计学意义(P>0.05),但新斯的明组7 d及30 d病死率低于常规治疗组(P<0.05)。结论百草枯患者早期加用新斯的明治疗,可减少TNF-α、IL-6炎性介质的合成,从而维持各个器官正常功能,减轻肺损伤,提高生存率。
Objective To investigate the therapeutic effect of neostigmine methionine on paraquat poisoning. Methods Forty-three patients with paraquat poisoning who were treated in our hospital from July 2014 to June 2016 were retrospectively analyzed. Patients were divided into routine treatment group (n = 21) and neostigmine group according to whether they were treated with neostigmine or not Group (n = 22). The levels of serum TNF-α, IL-6 and IL-10, APACHEⅡ and lung injury score (LIS) were compared between the two groups at 48 h after admission. Group 3 patients within the mortality rate. Results Serum levels of TNF-α, IL-6 and IL-10 on the day of admission were similar between the two groups (P> 0.05). After 2 days of treatment, the levels of serum TNF-α and IL-6 The level was significantly lower than the conventional treatment group (P <0.01). There was no significant difference in APACHEⅡscores and LIS scores between the two groups on the day of admission (P> 0.05). After 2 days of treatment, the APACHEⅡscore and LIS scores of neostigmine group were lower than those of the conventional treatment group (P <0.05). There was no significant difference in mortality rates between the two groups within 3 days (P> 0.05). However, the mortality rates at 7 and 30 days in neostigmine group were lower than those in the conventional treatment group (P <0.05). Conclusions The early administration of neostigmine in paraquat can reduce the synthesis of inflammatory mediators of TNF-α and IL-6, so as to maintain the normal function of various organs, relieve lung injury and improve the survival rate.