【摘要】 目的通过监测姜黄素干预下百草枯中毒(PQP)患者血清基质金属蛋白酶(MMP)9、组织金属蛋白酶抑制物(TIMP)1及肺部影像学的变化,探讨姜黄素对PQP患者肺纤维化的干预作用。方法选择2008年5月至2010年3月大连医科大学附属第一医院急诊科收治的PQP患者共61例,依据随机量表法分为姜黄素干预组(31例)和非姜黄素组(30例)。姜黄素干预组给姜黄素1000 mg/(kg·d),每日2次口服,两组其他治疗方案相同,采用双抗体夹心酶联免疫吸附法测定患者入院后第1、3、5、7、11天血清MMP-9、TIMP-1水平;并监测肺CT对PQP患者肺纤维化进展程度进行评估。结果姜黄素干预组与非姜黄素组在病死率方面的差异无统计学意义,但是姜黄素干预组的生存时间与对照组的差异有统计学意义(P<0.05)。非姜黄素干预组MMP-9、TIMP-1与姜黄素干预组比较各时点间的差异均有统计学意义(均P<0.05)。姜黄素干预组血清MMP-9、TIMP-1水平均显著低于同期非姜黄素组(P<0.05)。PQP患者肺CT检查,姜黄素干预组组肺纤维化程度较非姜黄素组显著减轻。结论 MMP-9及TIMP-1可能参与PQP肺纤维化的启动及进展过程,可作为临床生化指标联合CT等其他检查对肺纤维化的程度及预后做出评估。对PQP患者早期进行姜黄素干预治疗可降低血循环中MMP-9及TIMP-1水平,减轻肺纤维化程度,延缓病情发展,延长生存时间,但不能降低患者病死率。更多还原

【Abstract】 Objective To explore the intervention effect of curcumin on pulmonary fibrosis in patients with paraquat poisoning( PQP) by monitoring the changes of serum matrix metalloproteinase( MMP) 9,serum matrix metalloproteinase inhibitor( TIMP) 1,and lung imaging features of the patients. Methods A total of61 PQP patients admitted in Emergency Department of the First Affiliated Hospital of Dalian Medical University from May 2008 to Mar. 2010 were randomly divided into curcumin group( 31 cases) and non-curcumin group( 30 cases). Patients in both groups were treated by normal therapy,while patients in curcumin group orally took curcumin capsules 1000 mg /( kg · d),twice per day. Serum levels of MMP-9,TIMP-1 of the patients in both groups were detected by ELASA on the 1st,3th,5th,7th,11 thday after admission,and the degree of pulmonary fibrosis was evaluated by lung HRCT. Results There was no statistically significant difference in mortality rate between the two groups. However,the survival time of patients in curcumin group was longer than non-curcumin group,the difference was statistically significant( P < 0. 05). The levels of MMP-9 and TIMP-1 of curcumin group were significantly lower than those of the non-curcumin group during the same period( P < 0. 05). The degree of pulmonary fibrosis in patients of curcumin group reduced more significantly than of the non-curcumin group detected by lung HRCT. Conclusion MMP-9 and TIMP-1 may be involved in initiation and progression of pulmonary fibrosis. Serum levels of MMP-9 and TIMP-1 can be used as biochemical markers in clinical to evaluate the degree of pulmonary fibrosis and its prognosis combined with lung HRCT and other examinations. Early curcumin intervention for PQP patients can reduce the serum levels of MMP-9 and TIMP-1,reduce the degree of pulmonary fibrosis,suspend the progression of the disease,and prolong the survival time of the patients,but cannot reduce the mortality rate.更多还原