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.