摘要
目的:比较不同剂量的糖皮质激素治疗百草枯(PQ)中毒的临床疗效.方法:采用巢式病例对照研究方案.按纳入标准从136份住院病历中抽出23例组成试验组(大剂量组),按配对标准,从剩余病历中抽出46例,组成对照组(常规剂量组).试验组采用大剂量甲基强地松龙冲击和长疗程地塞米松维持治疗,对照组采用常规剂量糖皮质激素治疗.分析比较两组患者的死亡率、存活时间、生存率曲线和死亡原因.结果:两组患者入院时的主要临床特征基本相同,试验组患者的死亡率为65.2%(15/23),对照组为73.9%(34/46),两组相比无统计学差异(P=0.34),两组患者的平均存活时间[(21.3±10.3)dvs(17.6±10.4)d,P=0.17]和生存率曲线(P=0.24)也无统计学差异.呼吸衰竭是两组患者第一位死亡原因.结论:大剂量糖皮质激素在PQ中毒救治中的应用价值有待进一步的临床观察.
AIM . To investigate the effect of different dosage of steroid on treatment of paraquat poisoning. METHODS： A nested case-control study was designed. Retrospective analysis of 136 patients admitted with a diagnosis of paraquat poisoning over the last 3 years was performed. The experimental group （ n = 23 ） received initial pulse treatment methylprednisolone, followed by long-term dexamethasone therapy. The control group （n = 46） received conventional therapy. Mortality rate, survival status and death reasons between two groups were analyzed. RESULTS. There was no different distribution of basal variables between the two groups. The mortality rate （ 65.2% , 15/23 ） of the experimental group was not lower than that of the control group （73.9% , 34/46 ; P = 0.34 ）. Kaplan-meier survival analysis demonstrated no significant difference in acumulated survival rate between the two groups （P = 0.24）. Respiratory failure was the leading death cause in two groups. CONCLUSION： The novel steroid treatment does not reduce the mortality rate for patients with severe paraquat poisoning, its clinical value needs further investigation.
出处
《第四军医大学学报》
北大核心
2008年第10期912-914,共3页
Journal of the Fourth Military Medical University
