Therapeutic effect of neostigmine methylsulfate on paraquat poisoning

Yanyan WU; Jian HUANG; Jie LUO; Yang TAO; Li LU; Jinchuan ZHAO; Rong CHEN; Weizhi BAI

doi:10.16016/j.1000-5404.201611256

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Therapeutic effect of neostigmine methylsulfate on paraquat poisoning

Clinical Medicine | 更新时间：2026-01-09

- Therapeutic effect of neostigmine methylsulfate on paraquat poisoning
- Journal of Third Military Medical University Vol. 39, Issue 15, Pages: 1578-1581(2017)
- 作者机构：
  
  1.400014 重庆，重庆市急救医疗中心：急诊科
  2.400014 重庆，重庆市急救医疗中心：ICU
- 作者简介：
- 基金信息：
  
  the General Program of Medical Scientific Research of Chongqing Health and Family Planning Commission(20142082)
- DOI：10.16016/j.1000-5404.201611256
  CLC： R459.7;R453.9
- Received：30 November 2016，
  
  Revised：2017-02-07，
  
  Published：15 August 2017
- 稿件说明：
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Yanyan WU, Jian HUANG, Jie LUO, et al. Therapeutic effect of neostigmine methylsulfate on paraquat poisoning[J]. Journal of Third Military Medical University, 2017, 39(15): 1578-1581.
DOI：

Yanyan WU, Jian HUANG, Jie LUO, et al. Therapeutic effect of neostigmine methylsulfate on paraquat poisoning[J]. Journal of Third Military Medical University, 2017, 39(15): 1578-1581. DOI： 10.16016/j.1000-5404.201611256.

摘要

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(

=21) 及新斯的明组(

=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(APACHE Ⅱ)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(

＞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(

＜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(

＞0.05)；分别治疗2 d后，新斯的明组APACHE Ⅱ评分、LIS评分低于常规治疗组(

＜0.05)。两组患者在3 d内病死率差异无统计学意义(

＞0.05)，但新斯的明组7 d及30 d病死率低于常规治疗组(

＜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。

Abstract

Objective

To evaluate the efficacy of neostigmine methylsulfate in treatment of paraquat poisoning.

Methods

The clinical data were collected from 43 patients with paraquat poisoning treated at our center from July

2014 to June

2016. Twenty-one of the patients received conventional treatment and 22 received intramuscular injections of neostigmine (2 mg

twice daily for 7 consecutive days)

and in both groups

gastrointestinal decontamination

hemoperfusion

glucocorticoid

antioxidant therapy

cyclophosphamide and anticoagulant therapy were administered. The serum levels of tumor necrosis factor-α (TNF-α)

interleukin-6 (IL-6)

IL-10

APACHE Ⅱ score and lung injury score (LIS) were compared between the 2 groups both upon admission and at 2 d after commencement of the treatments. The mortality rates of the patients within 3 months were recorded and compared between the 2 groups.

Results

Before treatment

the serum levels of TNF-α

IL-6

IL-10

ACHE Ⅱ score and LIS were all comparable between the 2 groups. At 2 d after commencement of the treatments

the levels of TNF-α and IL-6

APACHE Ⅱ score and LIS were significantly lower in the neostigmine group than in the conventional treatment group (

0.05). The 3-day mortality rates were similar between the 2 groups

but at 7 and 30 days

the mortality rates were significantly lower in neostigmine group than in the conventional treatment group (

0.05).

Conclusion

Early intervention with neostigmine can reduce the production of such inflammatory cytokines as TNF-α and IL-6 to maintain the normal functions of the organs and alleviate lung injuries

thus promoting the survival of the patients with paraquat poisoning.

关键词

Keywords

references

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Yanyan WU

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