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甲硫酸新斯的明对百草枯中毒的疗效观察
Therapeutic effect of neostigmine methylsulfate on paraquat poisoning
- 第三军医大学学报 2017年39卷第15期 页码：1578-1581
- 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：
[黄健, E-mail:85408306@qq.com HUANG Jian, E-mail:85408306@qq.com
- 基金信息：重庆市卫生计生委医学科研项目：卫计委面上项目(20142082)
DOI：10.16016/j.1000-5404.201611256
中图分类号： R459.7;R453.9收稿：2016-11-30，
修回：2017-02-07，
纸质出版：2017-08-15
- 稿件说明：
移动端阅览
吴燕燕, 黄健, 罗杰, 等. 甲硫酸新斯的明对百草枯中毒的疗效观察[J]. 第三军医大学学报, 2017,39(15):1578-1581.
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.
吴燕燕, 黄健, 罗杰, 等. 甲硫酸新斯的明对百草枯中毒的疗效观察[J]. 第三军医大学学报, 2017,39(15):1578-1581. DOI： 10.16016/j.1000-5404.201611256.
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
2
探讨甲硫酸新斯的明对百草枯中毒的治疗作用。
方法
2
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(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
2
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APACHE Ⅱ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
2
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
2
To evaluate the efficacy of neostigmine methylsulfate in treatment of paraquat poisoning.
Methods
2
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
2
Before treatment
the serum levels of TNF-α
IL-6
IL-10
AP
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 (
P
<
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 (
P
<
0.05).
Conclusion
2
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
李海军, 赵兴勤, 谷琳琳, 等.急性百草枯中毒的研究和治疗进展[J].医学综述, 2012, 18(2): 264-266. DOI: 10.3969/j.issn.1006-2084.2012.02.037.
LI H J, ZHAO X Q, GU L L, et al . Progress of the research and treatment in acute paraquat poisoning[J ] . Med Recapitul, 2012, 18(2): 264-266. DOI:10.3969/j.issn.1006-2084.2012.02.037.
百草枯中毒诊断与治疗"泰山共识"专家组, 菅向东.百草枯中毒诊断与治疗"泰山共识"(2014)[J].中国工业医学杂志, 2014, 27(2): 117-119.
Professional Group of "Taishan" Expert Consensus on diagnoses and Treatment in Acute Paraquat Poisoning, JIAN X D. "Taishan" Expert Consensus on diagnoses and treatment in acute paraquat poisoning[J]. Chin J Industri Med, 2014, 27(2): 117-119.
菅向东, 刘会敏, 张伟, 等. 百草枯中毒救治"齐鲁方案"[C]. 第十三届全国劳动卫生与职业病学术会议论文集, 2014: 91-91.
JIAN X D, LIU H M, ZHANG W, et al . Qilu scheme on diagnoses and treatment in acute paraquat poisoning[C ] . Proceedings of the 13th National Conference on Labor Hygiene and Occupational Diseases of China, 2014: 91-91.
XIE H, WANG R, TANG X, et al . Paraquat-induced pulmonary fibrosis starts at an early stage of inflammation in rats[J ] . Immunotherapy, 2012, 4(12): 1809-1815. DOI: 10.2217/imt.12.122.
BOROVIKOVA L V, IVANOVA S, ZHANG M, et al . Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin[J ] . Nature, 2000, 405(6785): 458-462. DOI: 10.1038/35013070.
DE JONGE W J, VAN DER ZANDEN E P, THE F O, et al . Stimulationof the vagus nerve attenuates macrophage activation by activating the Jak2-STAT3 signaling pathway[J ] . Nat Immunol, 2005, 6(8): 844-851. DOI: 10.1038/ni1229.
WANG H, LIAO H, OCHANI M, et al . Cholinergic agonists inhibit HMGB1 release and improve survival in experimental sepsis[J ] . Nature Medicine, 2004, 10(11): 1216-1221. DOI: 10.1038/nm1124.
PAVLOV V A, TRACEY K J. The vagus nerve and the inflammatory reflex--linking immunity and metabolism[J]. Nat Rev Endocrinol, 2012, 8(12): 743-754. DOI: 10.1038/nrendo.2012.189.
ULLOA L. The vagus nerve and the nicotinic anti-inflammatory pathway[J]. Nat Rev Drug Discov, 2005, 4(8): 673-684. DOI: 10.1038/nrd1797.
LIU Z, WANG Y, WANG Y, et al . Dexmedetomidine attenuates inflammatory reaction in the lung tissues of septic mice by activating cholinergic anti-inflammatory pathway[J ] . Int Immunopharmacol, 2016, 35: 210-216. DOI: 10.1016/j.intimp.2016.04.003.
GOVERSE G, STAKENBORG M, MATTEOLI G. The intestinal cholinergic anti-inflammatory pathway[J]. J Physiol (Lond), 2016, 594(20): 5771-5780. DOI: 10.1113/JP271537.
KOLGAZI M, OZGUR F, BEYAZOGLU O, et al . Role of the cholinergic anti-inflammatory pathway in endotoxemia-induced multi-organ damage in the rat[J ] . Journal of Marmara University Institute of Health Sciences, 2015: 1. DOI: 10.5455/musbed.20150306053623.
XIANG H, HU B, LI Z, et al . Dexmedetomidine controls systemic cytokine levels through the cholinergic anti-inflammatory pathway[J ] . Inflammation, 2014, 37(5): 1763-1770. DOI: 10.1007/s10753-014-9906-1.
STERNBERG E M. Neural regulation of innate immunity: a coordinated nonspecific host response to pathogens[J]. Nat Rev Immunol, 2006, 6(4): 318-328. DOI: 10.1038/nri1810.
黄祥君, 袁波.新斯的明临床应用不良反应分析[J].中国社区医师(医学专业), 2012, 14(13): 32-33. DOI: 10.3969/j.issn.1007-614x.2012.13.028.
HUANG X J, YUAN B. Analysis of adverse reactions in clinical application of neostigmine[J]. Chin Commu Doc (Med Ed), 2012, 14(13): 32-33. DOI: 10.3969/j.issn.1007-614x.2012.13.028.
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