Effect of anisodamine combined with blood purification on pulmonary fibrosis, serum matrix metalloproteinase-9 and matrix metalloproteinase 1 levels in patients with paraquat poisoning / 中国医师杂志

ABSTRACT

Objective To investigate the effect of anisodamine combined with blood purification on pulmonary fibrosis and levels of serum matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase 1 (TIMP1) in patients with paraquat poisoning.Methods From March 2013 to February 2017,84 patients with paraquat poisoning admitted to our hospital were enrolled in the observation group (anisodamine +blood purification) or control group (blood purification),42 cases in each group.The curative effect,indexes related to pulmonary fibrosis,serum MMP-9 and TIMP1 levels were compared between the two groups.The incidence of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) and intensive care uni (ICU) admission time were recorded.Results There was significant difference (P ＜ 0.05) in the total effective rate (88.1％ vs 69.0％) and the high-resolution computed tomography (CT) score after 7 days of treatment (8.4 ± 0.9 vs 12.3 ± 1.4) between the observation group and the control group.At the same time,the serum levels of hyaluronic acid and type Ⅳ collagen in the two groups showed an upward trend with significant difference (P ＜ 0.05).After 1 day of treatment,the serum levels of MMP-9 and TIMP1 in the observation group reached a peak,then gradually decreased,with significant difference (P ＜0.05).The incidence of ALI/ARDS in the observation group and the control group (11.9％ vs 31.0％)and the duration of ICU treatment [(10.2 ± 3.2) d vs (13.2 ± 2.8) d].Conclusions For patients with acute paraquat poisoning,the combination of anisodamine and blood purification can down-regulate the expressions of MMP-9 and TIMP1 and delay the progression of pulmonary fibrosis,thus improving the clinical therapeutic effect.