中国全科医学Issue(8)：933-936,4.DOI:10.3969/J.iSSn.1007-9572.2015.08.018
强化血液灌流对急性百草枯中毒患者血清百草枯清除率和预后的影响
Clearance Rate of Strengthened Hemoperfusion for Acute Paraquat Poisoning and Its Effects on PatientsˊPrognosis
摘要
Abstract
Objective To explore the clearance rate of strengthened hemoperfusion( sHP) for acute paraquat( PQ) poisoning and its effects on patientsˊprognosis. Methods 51 PQ poisoning patients admitted to the First Peopleˊs Hospital of Lianyungang from March 2010 to October 2013 were divided, according to visiting time, into groups convention HP ( CHP group,n=25),strengthened HP(sHP group,n =26),another 14 patients who refused HP treatment enrolled in control group. All patients were given comprehensive treatment. CHP group given 1 HP treatment and sHP group given 3 ( the intervals was 6 h) after gastrolavage. A PQ standard curve was established. Venous blood was drawn and PQ concentration gained to calculate PQ clearance rates before HP(T1),instantly after HP(T2),at 8 h after HP(T3),at 16 h after HP(T4)in 3 groups. Creatinine( Cr ), blood urea nitrogen ( BUN ), white blood cell ( WBC ), aspartate aminotransferase ( AsT ), alanine aminotransferase( ALT) and were monitored dynamically. Results There was no significant difference in gender,age, poison amount,time from taking poison to hospital admission,PQ concentration at admission,Cr at admission,BUN peak, ALT peak,AsT peak,WBC peak among 3 groups(P>0. 05). There was a good linear correlation at 0. 25-16. 00 mg/L in PQ standard curve(y=0. 031 6x+0. 011 2). There was difference in serum PQ concentration among 3 groups at different time points(P<0. 05). In group comparison,PQ concentration was lower in sHP group than in control group at T2,T3,T4, lower in CHP group than in control group at T2(P<0. 05). In intra-group comparison,PQ was lower at T2,T3,T4 than at T1 in groups sHP,CHP(P<0. 05),lower at T3,T4 than at T1 in control group(P<0. 05). The 3 clearance rates of group sHP were 62%(16/26),42%(11/26),31%(8/26),respectively,the difference was significant(χ2 =5. 079,P <0. 05). The clearance rate of CHP was 56%(14/25). There was no difference between clearance rate of group CHP and the first clearance rate of sHP(χ2 =0. 161,P>0. 05). Kaplan-Meier survival curve showed that the survival rate was 46. 2% in sHP group(12/26),36. 0% in CHP group(9/25),14. 3% in control group(2/14);the difference was significant(χ2 =7. 206,P=0. 027). The survival rate was higher in sHP group than in control group(χ2 =7. 375,P=0. 007),there was no difference between groups sHP,CHP(χ2 =1. 337,P=0. 248)or between groups CHP,control(χ2 =2. 568,P=0. 109). Conclusion sHP may increase patientsˊ survival rate and improve their survival state. single HP is inferior to sHP in effectiveness. Patients with acute PQ should be given early,repeated HP treatment based on comprehensive treatment. The intervals between HP treatments should be no more than 6 h.关键词
百草枯/电泳,毛细管/灌流/清除/预后Key words
Paraquat/Electrophoresis,capillary/Perfusion/Clearance/Prognosis分类
医药卫生引用本文复制引用
莫军,陈晓兵,许铁,王言理,刘克喜..强化血液灌流对急性百草枯中毒患者血清百草枯清除率和预后的影响[J].中国全科医学,2015,(8):933-936,4.基金项目
江苏省卫生厅科技项目 （）
