目的:研究乌司他丁联合血液灌流对百草枯中毒患者肾功能、纤维化指标及氧化应激指标的影响.方法:选择青海省人民医院收治的百草枯中毒患者作为研究对象,均接受血液灌流治疗并根据病史资料中是否使用乌司他丁分为乌司他丁组和对照组.治疗前及治疗后一周时,测定肾功能标志物、纤维化指标及氧化应激指标.结果:与组内治疗前比较,治疗后血清中Scr 、BUN 、Cys-C 、β2-MG 、TGF-β1 、ICAM-1 、MMP9 、PICP 、C-IV 、MDA的含量以及外周血中Nrf2 、HO-1的表达强度均显著降低,血清中CAT 、SOD的含量均显著升高且乌司他丁组患者治疗后血清中 Scr 、BUN 、Cys-C 、β2-MG 、TGF-β1 、ICAM-1 、MMP9 、PICP 、C-IV 、MDA的含量以及外周血中Nrf2 、HO-1的表达强度均显著低于对照组,血清中CAT 、SOD的含量均显著高于对照组.结论:乌司他丁联合血液灌流治疗对百草枯中毒患者肾功能、肺纤维化及氧化应激均具有改善价值.%Objective :To study the effects of ulinastatin combined with hemoperfusion on renal function ,fibrosis inde-xes and oxidative stress indexes of patients with paraquat poisoning.Methods :Patients with paraquat poisoning who were trea-ted in Qinghai Provincial People's Hospital between March 2014 and May 2017 were chosen as the research subjects ,treated with hemoperfusion and divided into ulinastatin group and control group according to the use of ulinastatin or not in history da-ta.The renal function markers ,fibrosis indexes and oxidative stress indexes were measured before treatment and 1 week after treatment.Results :Compared with those of same group before treatment ,serum Scr ,BUN ,Cys-C ,β2-MG ,TGF-β1 ,ICAM-1 ,MMP9 ,PICP ,C-IV and MDA levels as well as peripheral blood Nrf2 and HO-1 expression intensity significantly decreased whereas serum CAT and SOD levels significantly increased after treatment (P＜0.05) ,and serum Scr ,BUN ,Cys-C ,β2-MG , TGF-β1 ,ICAM-1 ,MMP9 ,PICP ,C-IV and MDA levels as well as peripheral blood Nrf2 and HO-1 expression intensity of uli-nastatin group after treatment were significantly lower than those of control group whereas serum CAT and SOD levels were significantly higher than those of control group (P＜0.05).Conclusion :Ulinastatin combined with hemoperfusion can improve the renal function ,pulmonary fibrosis and oxidative stress in patients with paraquat poisoning.
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