不同剂量甲基强的松龙治疗百草枯中毒患者疗效观察

发布时间：2018-05-23 21:10

本文选题：百草枯 + 甲基强的松龙　；参考：《重庆医学》2017年04期

【摘要】：目的观察不同剂量甲基强的松龙治疗百草枯(PQ)中毒患者的疗效。方法共将89例百草枯中毒患者按照不同的中毒程度分组,不同亚组中常规组应用常规治疗加甲基强的松龙(1mg·kg-1·d-1),强化组在常规治疗基础上加大剂量甲基强的松龙应用(1g/d)。结果在中毒患者中,随着中毒剂量的加大,患者的肝损伤、肾损伤、心肌损伤和呼吸衰竭的发生率显著增加,病死率也明显升高(P0.01)。在病死率对比上,甲基强的松龙治疗轻度、重度中毒患者组间差异无统计学意义(P0.05);在口服PQ剂量20~40mg/kg的两组对比中,尽管病死率强化组与常规组比较差异无统计学意义(P=0.16),但有一定的差异(44.44%vs.71.43%)。回归分析发现,心肌损伤、呼吸衰竭(OR=8.71、41.51)可增加患者死亡危险。结论大剂量甲强龙治疗中度PQ中毒患者,可能会降低患者的病死率。出现心肌损伤、呼吸衰竭提示患者可能预后差。
[Abstract]:Objective to observe the efficacy of methylprednisolone in the treatment of paraquat PQ poisoning. Methods A total of 89 paraquat poisoning patients were divided into two groups according to different degree of poisoning. The routine treatment group was treated with methylprednisolone 1mg kg-1 d-1g in different subgroups, and the intensive group was given methylprednisolone (1 g / d) on the basis of routine treatment. Results the incidence of liver injury, renal injury, myocardial injury and respiratory failure were significantly increased with the increase of poisoning dose, and the mortality was also significantly increased (P 0.01). There was no significant difference in mortality between patients with mild and severe poisoning treated with methylprednisolone (P0. 05%), and there was no significant difference between the two groups in oral PQ dose of 20~40mg/kg. Although there was no significant difference in mortality between the intensive group and the routine group, there was a certain difference between the two groups, but there was a certain difference between the two groups (44.44vs.71.43g). Regression analysis showed that myocardial injury and respiratory failure increased the risk of death. Conclusion treatment of moderate PQ poisoning with high dose of methylenolone may reduce the mortality of patients with PQ poisoning. Myocardial injury and respiratory failure suggest poor prognosis.
【作者单位】：河南省卫辉市新乡医学院第一附属医院重症医学科;新乡医学院生命科学技术学院;
【基金】：河南省科技厅科技攻关项目(082102310119)
【分类号】：R595.4

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