Observation on the effect of high-dose ambroxol combined with acetylcysteine in the early treatment of paraquat-induced pulmonary fibrosis
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摘要: 目的 观察大剂量氨溴索联合乙酰半胱氨酸早期应用对百草枯中毒患者肺纤维化的疗效。 方法 回顾性分析2016年5月-2017年5月无锡市第三人民医院进行治疗的90例百草枯中毒患者,采用随机数字表法将其随机分成对照组(使用丹红注射液)及观察组(大剂量氨溴索联合乙酰半胱氨酸组),2组患者的基线资料差异无统计学意义(P>0.05),给予所有患者对症支持治疗,如镇静、镇痛、口腔护理等,预防相关并发症。同时,在对所有患者给予甲强龙治疗的基础上,加用大剂量的氨溴索,观察组在对照组的基础上给予乙酰半胱氨酸泡腾片口服。严密观察患者呼吸功能,监测患者肾功能、大小便等情况。观察2组患者的存活率、肺纤维化发生率和肺纤维化程度。 结果 观察组患者与对照组患者在相同时间点的存活率比较差异无统计学意义(P>0.05),2组患者在相同时间点肺纤维化的发生率差异无统计学意义(P>0.05);观察组患者肺纤维化程度显著低于对照组患者,差异有统计学意义(P<0.05)。 结论 相比于丹红注射液,大剂量氨溴索联合乙酰半胱氨酸并未显著提高百草枯中毒肺纤维化患者的存活率,同时并未显著降低患者肺纤维化发生率,但显著改善患者的早期肺纤维化程度及临床症状,效果显著。Abstract: Objective To observe the effect of high-dose ambroxol combined with acetylcysteine on pulmonary fibrosis in patients with paraquat poisoning. Methods A retrospective analysis was made on 90 patients with paraquat poisoning treated in the Third People's Hospital of Wuxi City from May, 2016 to May, 2017. The patients were randomly divided into control group by random number table method (using Dan red injection) and observation group (large dose ammonia bromine joint acetylcysteine group). General information of the two groups were comparable. All patients were given symptomatic support treatment, prevent related complications, such as a sedative and analgesic, oral care, etc. At the same time, large doses of ambroxol were added to all patients on the basis of methylprednisolone treatment, and acetylcysteine effervescent tablets were administered to the observation group on the basis of the control group. The respiratory function of the patients was closely observed, and the renal function, urine and feces of the patients were monitored. Survival rate, incidence of pulmonary fibrosis and degree of pulmonary fibrosis were observed. Results According to the analysis of patients' inpatient registration, the difference in survival rate between the observation group and the control group at the same time point was not statistically significant (P>0.05), and the difference in incidence of pulmonary fibrosis between the two groups at the same time point was not statistically significant (P>0.05). The degree of pulmonary fibrosis in the observation group was significantly lower than that in the control group,and the difference was statistically significant (P<0.05). Conclusion Comparing with Danhong injection alone, the survival rate is not significantly improved in the group of high-dose ambroxol combined with acetylcysteine in the early clinical treatment of paraquat-induced pulmonary fibrosis patients, the incidence of pulmonary fibrosis is not significantly reduced.However, the degree of clinical symptoms can be improved. It is worthy to be promoted due to high safety and efficacy.
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Key words:
- Paraquat poisoning /
- Ambroxol /
- Acetylcysteine /
- Pulmonary fibrosis
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