Effects of early pulse therapy with large dose of methylprednisolone associated with cyclosporine A on the prognosis of patients with paraquat poisoning / 解放军医学杂志

ABSTRACT

Objective To observe the effects of early pulse therapy with large dose of methylprednisolone associated with cyclosporine A on mortality and incidence of pulmonary fibrosis in the patients with peroral paraquat poisoning.Methods Initial pulse therapy with large dose of methylprednisolone associated with cyclosporine A was given in early period,in addition to regular gastric lavage and hemoperfusion,after acute peroral paraquat poisoning in 38 patients.The indexes of arterial blood gas analysis,findings of lung CT,and the function of kidney and liver were all monitored periodically.At the same time,the data of mortality and incidence of pulmonary fibrosis of the patients with peroral paraquat poisoning were statistically analyzed.Results 13 of 38 patients died,the mortality was 34.2%.Among the dead,12 patients died of multiple organ failure within 1 week after paraquat poisoning,and the remaining one died of pulmonary fibrosis.During hospitalization of the other 25 patients who survived,blood oxygenation index declined in different degrees in 18 cases,the thoracic computed tomography showed interstitial changes in the lung in 17 cases,and dysfunction of more than two organs(lung,liver and kidney)was found in 13 cases.Conclusion The pulse therapy of large dose of methylprednisolone associated with cyclosporine A given in early period may markedly improve the prognosis of patients with acute peroral paraquat poisoning.But a large sample with randomized double blind study is needed in order to further evaluate the clinical efficacy.