Efficacy of combined use of acetylcysteine and methylprednisolone in the treatment of paraquat poisoning

Abstract

Purpose: To investigate the clinical impact of combined application of acetylcysteine and methylprednisolone in treating paraquat poisoning (PQP).Methods: The clinical data of 92 PQP patients who received treatment in our hospital for 1 year were analyzed. The patients were equally divided into control group (CG) and study group (SG), based on treatment plans. All patients underwent routine acute-phase treatment, while SG was additionally treated with acetylcysteine in combination with methylprednisolone. After treatment, the renal function, pulmonary fibrosis indices and inflammatory factor levels of both groups were determined.Results: During the 1 - 4 weeks of treatment, there was no statistical difference in the survival rates of patients at various time periods (p > 0.05). After treatment, there were markedly lower levels of blood urea nitrogen (BUN) and serum creatinine (SCr) in SG than in CG. There was lower incidence of pulmonary fibrosis in SG than in CG, although the difference was not significant. Patients in SG had lower HRCT scores and levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) than those in CG (p < 0.05).Conclusion: Acetylcysteine in combination with methylprednisolone significantly reduces the degree of pulmonary fibrosis and improves renal function and inflammatory levels. It has a positive implication for early treatment of patients, especially for the prognosis of patients with mild-to-moderate poisoning. Therefore, the combined therapy has potential for clinical application.