谢皓空
XIE Haokong(Department of Emergency

• 1:永州市中心医院南院急诊科

摘要(Abstract)：

目的:研究血清超氧化物歧化酶(SOD)、一氧化氮(NO)和转移生长因子β1(TGF-β1)在急性1-1-二甲基-4-4-联吡啶阳离子盐(百草枯)中毒致肺损伤患者血清中的变化及意义。方法:78例百草枯中毒患者分别于入院时、中毒后24 h、48 h和72 h采集静脉血2 ml,采用黄嘌呤氧化酶法和硝酸还原酶法测定SOD和NO水平,采用酶联免疫吸附法检测TGF-β含量,并与正常健康查体者相对照,所有病人均行肺部高分辨CT检查。结果:78例百草枯中毒者经救治后存活15例,死亡63例,死亡率为80.77%。急性百草枯中毒患者血清SOD水平较对照组明显降低,并于中毒后48 h降至最低(P<0.05),NO及TGF-β1水平均明显升高(P<0.05),其中,NO水平于中毒后持续升高,并于48 h达高峰后缓慢下降(P<0.05);TGF-β1水平则随时间延长逐渐上升。结论:百草枯中毒后肺损害的发病机制可能与氧化还原性损伤及肺纤维化有关,检测SOD、NO及TGF-β1水平可作为评估百草枯中毒患者肺损害程度与判断预后的临床指标之一。
Objective: To study the changes of serum superoxide dismutase(SOD),nitric oxide(NO) and transforming growth factor β1(TGF-β1) levels in patients with lung injury induced by acute paraquat poisoning and thier clinical significance.Methods: Blood samples of 78 cases with acute paraquat poisoning were taken on admission and at 24 h,48 h,72 h after poisoning.The levels of SOD,NO and TGF-β1 were measured with xanthine oxidase method,nitrate reductase method and enzyme-linked immunosorbent assay respectively.High-resolution CT was performed in all the patients.Results: Fifty cases survived,63 cases died,and the mortality was 80.77%.The serum level of SOD in patients was significantly lower than that in the control group,and reached the lowest at 48 h after poisoning(P<0.05).NO and TGF-β1 levels in patients were significantly higher than those in the control group(P<0.05),and NO level continuously elevated,and reached peak at 48h,and then decreased slowly(P<0.05),while TGF-β1 level gradually increased with the time passing.Conclusions: The pathogenesis of lung injury in acute paraquat poisoning patients may be related to oxidation injury and pulmonary fibrosis,and detection of serum SOD,NO and TGF-β1 levels in patients with paraquat poisoning could be effective in evaluating lung injury degree and judging prognosis.

关键词(KeyWords)： 百草枯;农药;中毒;肺;超氧化物歧化酶;一氧化氮;转化生长因子β
paraquat;pesticides;poisoning;lung;superoxide dismutase;nitric oxide;transforming growth factor beta

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 谢皓空
XIE Haokong(Department of Emergency

DOI: 10.19367/j.cnki.1000-2707.2012.04.011

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