Clinical Pathological Analysis of Death from Paraquat Poisoning_West China Medical Journal

Authors：

 ZHUPeng ¹ , LIUYuan ¹ , ZHUHai-biao ¹ , ZIJia-ji ² , CHENXia-meng ¹ , YANGYu ¹ ,  GUANPeng ¹

1. Department of Forensic Pathology, West China School of Preclinical and Forensic Science, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. School of Basic Medical Sciences, Dali University, Dali, Yunnan 671000, P. R. China;

Corresponding?author：

GUANPeng, Email: guanpengcn@yahoo.com

Keywords：

Paraquat poisoning; Pulmonary fibrosis; Forensic pathology

DOI：

10.7507/1002-0179.20140276

Video：

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Objective To analyze the clinical and pathologic features of paraquat poisoning, discuss the damage mechanism of pulmonary fibrosis caused by paraquat poisoning. Methods We retrospectively analyzed the paraquat poisoning-related cases collected in recent years from January 2010 to December 2013, and compared the clinical features and pathologic changes between acute and chronic paraquat poisoning cases. Results The main clinical and pathologic manifestation of paraquat poisoning was multiple organ damage, especially with lung as its target organ. In acute poisoning deaths, the lung injury was characterized by the pulmonary edema and formation of lung transparent membrane; In chronic poisoning deaths, the injury was characterized by the formation of lung transparent membrane and pulmonary fibrosis. Conclusion In order to make an earlier diagnosis in clinical cases, we should strengthen the cognition of clinical manifestations and damage mechanism of paraquat poisoning. To obtain an accurate conclusion in forensic medicine appraisal, we should draw a comprehensive analysis of the forensic case, the clinical data, the toxicological analysis and the autopsical results.

Citation： ZHUPeng, LIUYuan, ZHUHai-biao, ZIJia-ji, CHENXia-meng, YANGYu, GUANPeng. Clinical Pathological Analysis of Death from Paraquat Poisoning. West China Medical Journal, 2014, 29(5): 910-913. doi: 10.7507/1002-0179.20140276 Copy

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14.	蔡琳, 吳壯, 徐軍. 博萊霉素誘導α平滑肌肌動蛋白Cre重組酶轉基因小鼠肺纖維化上皮細胞-間質轉分化的研究[J]. 中國呼吸與危重監護雜志, 2009, 8(1):52-56.
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1. 李建云, 汪秀蘭, 張華, 等. 2例百草枯中毒死亡病例護理討論報告[J]. 天津護理, 2012, 20(2):75-76.
2. 韋建華, 李航天. 急性百草枯中毒死亡1例報告[J]. 職業與健康, 2006, 22(1):66-67.
3. Hwang KY, Lee EY, Hong SY. Paraquat poisoning in Korea[J]. Arch Environ Health, 2002, 57(2):162-166.
4. 皮麗娟, 祝偉. 百草枯中毒致肺損傷的作用機制及治療新進展[J]. 內科急危重癥雜志, 2013, 19(4):236-238.
5. 黃光照. 法醫毒理學[M]. 3版. 北京:人民衛生出版社, 2004:197.
6. 劉鵬, 梁宇光, 何躍忠, 等. 百草枯中毒的基礎研究及救治進展[J]. 中國工業醫學雜志, 2010, 23(5):364-366.
7. 楊明, 劉瑩, 蔣劍峰, 等. 百草枯中毒死亡30例尸解分析[J]. 西部醫學, 2008, 20(4):826, 828.
8. 王永進. 百草枯中毒治療的研究進展[J]. 中國急救醫學, 2003, 23(6):49-51.
9. 賴伯才. 百草枯中毒致急性肺損傷的機制及其治療進展[J]. 基層醫學論壇, 2013, 17(28):3772-3774, 3777.
10. 金克煒. 肺癌的肺透明膜形成[J]. 云南醫藥, 1990, 11(1):54-56.
11. Selman M, King TE, Pardo A, et al. Idiopathic pulmonary fibrosis:prevailing and evolving hypotheses about its pathogenesis and implications for therapy[J]. Ann Intern Med, 2001, 134(2):136-151.
12. Willis BC, Dubois RM, Borok Z. Epithelial origin of myofibroblasts during fibrosis in the lung[J]. Proc Am Thorac Soc, 2006, 3(4):377-382.
13. Rho JK, Choi YJ, Lee JK, et al. Epithelial to mesenchymal transition derived from repeated exposure to gefitinib determines the sensitivity to EGFR inhibitors in A549, a non-small cell lung cancer cell line[J]. Lung Cancer, 2009, 63(2):219-226.
14. 蔡琳, 吳壯, 徐軍. 博萊霉素誘導α平滑肌肌動蛋白Cre重組酶轉基因小鼠肺纖維化上皮細胞-間質轉分化的研究[J]. 中國呼吸與危重監護雜志, 2009, 8(1):52-56.
15. 高振芹, 胡永斌, 彭勁武, 等. ERK信號通路調控二氧化硅誘導的人支氣管上皮細胞上皮-間質轉化[J]. 中南大學學報·醫學版, 2011, 36(11):1085-1089.

West China Medical Journal

Clinical Pathological Analysis of Death from Paraquat Poisoning

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