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目的探讨急性百草枯中毒肺损伤患者的血清肿瘤坏死因子(TNF)-α与白细胞介素(IL)-6水平和大剂量盐酸氨溴索(HAMB)干预的影响。方法将31例急性百草枯中毒肺损伤患者分为HAMB治疗组16例和常规治疗组15例,采用酶联免疫吸附法检测2组患者治疗前、治疗后3d以及12例健康对照组的TNF-α和IL-6的水平,并予对比;并进行治疗前、后肺损伤评分(LIS)。结果急性百草枯中毒肺损伤患者血清TNF-α和IL-6的水平较健康对照组显著增高(P<0.01);2组患者治疗后血清TNF-α和IL-6的水平以及LIS均较治疗前有显著改善(P<0.01),但HAMB治疗组较常规治疗组改善更明显(P<0.05)。结论急性百草枯中毒肺损伤患者存在炎性细胞因子水平的高表达,炎症反应参与了急性百草枯中毒肺损伤的发病过程;HAMB的干预能一定程度地抑制促炎因子的水平,对减轻或延缓中毒性肺损伤有积极的保护作用。
Objective To investigate the effect of serum level of tumor necrosis factor-α (TNF-α), interleukin (IL) -6 and high dose ambroxol hydrochloride (HAMB) on acute paraquat poisoning lung injury. Methods Thirty-one patients with acute paraquat poisoning lung injury were divided into two groups: HAMB treatment group (16 cases) and routine treatment group (15 cases). Enzyme-linked immunosorbent assay (ELISA) was used to detect TNF- α and IL-6 levels, and compared; and before and after treatment, lung injury score (LIS). Results Serum levels of TNF-α and IL-6 in patients with acute paraquat poisoning lung injury were significantly higher than those in healthy controls (P <0.01). The levels of serum TNF-α, IL-6 and LIS in the two groups were significantly higher than those in the control group (P <0.01), but the HAMB treatment group improved more significantly than the conventional treatment group (P <0.05). Conclusions There is a high expression of inflammatory cytokines in acute paraquat poisoning lung injury patients. Inflammatory reaction is involved in the pathogenesis of acute paraquat poisoning lung injury. HAMB intervention can inhibit the level of proinflammatory cytokines to a certain extent and reduce or delay Toxic lung injury has a positive protective effect.