Clinical study of sequential glucocorticoids in the treatment of acute mercury poisoning complicated with interstitial pneumonia
10.3760/cma.j.cn121094-20191009-00468
- VernacularTitle:序贯式糖皮质激素治疗急性汞中毒并发间质性肺炎的临床研究
- Author:
Zhimin FAN
1
;
Haiyan SHAO
;
Bei YANG
;
Zhipeng DONG
;
Wenwen LIU
;
Maogong SHI
Author Information
1. 264025 烟台市烟台山医院职业病科
- Keywords:
Mercury poisoning;
Pneumonia;
Lung diseases, interstitial;
Glucocorticoids;
Sequential treatment
- From:
Chinese Journal of Industrial Hygiene and Occupational Diseases
2020;38(8):621-624
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the clinical efficacy of sequential glucocorticoids in the treatment of acute mercury poisoning complicated with interstitial pneumonia.Methods:Retrospective analysis of 37 patients with acute mercury poisoning complicated with interstitial pneumonia admitted from January 2009 to April 2019, including the sequential treatment group (15 cases) and the conventional treatment group (22 cases) , all patients were treated with sodium dimercaptopropane sulfonate, and given anti-inflammatory, liver-protecting and other drugs for symptomatic treatment. The conventional treatment group was given methylprednisolone 1mg/kg once a day for 5-7 days. The sequential treatment group was given 1 mg/kg of methylprednisolone once a day for 5-7 days, then gradually reduced to 20 mg, and the total course of treatment was 14-21 days. To observe the changes of clinical symptoms, signs, lung function including forced vital capacity (FVC) , forced expiratory volume in the first second (FEV 1) and ratio of forced expiratory volume in the first second to forced vital capacity (FEV 1/FVC) , and chest CT indexes before and after treatment in the two groups. Results:The clinical symptoms and signs of the two groups were significantly improved compared with those before treatment, and there was no significant difference between the apparent efficiency and the total effective rate of the two groups ( P>0.05) . The FVC, FEV 1, and FEV 1/FVC of the two groups were significantly higher than those before treatment. After treatment, the indexes of the sequential treatment group were significantly higher than that of the conventional treatment group, and the difference was statistically significant ( P<0.05) . The apparent efficiency (93.3%, 14/15) of CT lesions in the sequential treatment group was significantly higher than those of the conventional treatment group (59.1%, 13/22) , and the difference was statistically significant ( P< 0.05) . Conclusion:Sequential glucocorticoid treatment of acute mercury poisoning complicated with interstitial pneumonia could improve the effect of clinical signs and symptoms which is equal to conventional treatment, but it could better promote the recovery of lung function and the absorption of lung lesions.
