Effect of blood purification combined with acetylcysteine on acute paraquat poisoning and pulmonary fibrosis
Li Jiabei
Chang Jianxiang
Li Zhongxian
Abstract：Objective To analyze the effect of blood purification combined with acetylcysteine on acute paraquat poisoning and pulmonary fibrosis.Methods From June 2016 to May 2018,82 patients with acute paraquat poisoning admitted to Shaoyang Central Hospital were randomly divided into control group and observation group,with 41 cases in each group.The control group had routine gastric lavage,catharsis,acid-base water-electrolyte balance control,stomach-protecting,kidney-protecting treatments and blood purification.The observation group took acetylcysteine effervescent tablets on the basis of control group.Mechanical ventilation rate,incidences of hyoxemia and type Ⅰ respiratory failure,the 14-day mortality rate,incidence of pulmonary fibrosis after 1 and 4 weeks of treatment were observed.Oxygenation index,alveolar-arterial differential oxygen pressure,liver function indexes(alanine aminotransferase and aspartate aminotransferase),renal function index (serum creatinine) and myocardial enzyme(creatine kinase isoenzyme) were detected before and 2 weeks after treatment.Results Mechanical ventilation rate,incidences of hyoxemia and type Ⅰ respiratory failure and the 14-day mortality rate in the observation group were significantly lower than those in the control group [73.2％ (30/41) vs 95.1％ (39/41),36.6％ (15/41) vs 73.2％ (30/41),31.7％ (13/41) vs 75.6％ (31/41),26.8％ (11/41) vs 58.5％ (24/41)] (all P ＜0.05).After 4 weeks of treatment,incidence of pulmonary fibrosis in the observation group was significantly lower than that in the control group[39.0％ (16/41) vs 56.1％ (23/41)] (P ＜0.05).Mter 2 weeks of treatment,oxygenation index significantly increased and it was higher in the observation group than that in the control group [(403 ± 16) mmHg vs (395 ± 14)mmHg];alveolar-arterial differential oxygen pressure significantly decreased and it was lower in the observation group than that in the control group[(23.5 ±4.5) mmHg vs (27.1 ±3.2)mmHg];serum levels of alanine aminotransferase,aspartate aminotransferase,serum creatinine and creatine kinase isoenzyme in the observation group were significantly lower than those before treatment and those in the control group (all P ＜0.05).Conclusion Blood purification combined with acetylcysteine can improve the rescue effect on acute paraquat poisoning,promote the recovery of liver and kidney function,inhibit the progress of pulmonary fibrosis,reduce myocardial injury and improve the prognosis.
Keywords：Acute paraquat poisoningAcetylcysteineBlood purificationPulmonary fibrosis
Publication Date：2020-01-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 45-48 )