中国实用内科杂志2017，Vol.37Issue(7)：621-625,5.DOI:10.19538/j.nk2017070112
血液灌流并连续性肾脏替代治疗和透析滤过治疗百草枯中毒疗效研究
Analysis of paraquat elimination by hemoperfusion combined with hemodiafiltration or continuous veno-venous hemofiltration on acute paraquat poisoning
摘要
Abstract
Objective To explore the paraquat(PQ) elimination by combining two blood purification methods,HP+HDF and HP+CVVH,in acute PQpoisoning.Method Sixteen patients with acute PQpoisoning were enrolled in this research,who were treated from August 2013 to December 2015 in Shanghai Tenth People's Hospital.The patients were divided into HP+HDF group (n=7) and HP+CVVH group (n=9).The concentrations of PQin serum and urine samples were compared between the two groups.The liver and kidney functions at 3 days and 7 days were also compared.Results (1)The serum level of PQwas significantly decreased in both groups (P＜0.01).(2)The extraction rate and clearance rate of PQin HP+HDF group were higher than that of HP+CVVH group (P＜0.05).(3)In the HP+HDF group,the serum concentration of PQwas reduced in the first 2 hours,but serum concentration of PQin 3 patients was elevated.On the contrary,in the HP+CVVH group,the serum concentration of PQwas reduced in the first 12 hours,and maintained at low level till the end of the blood purification.(4)After the blood purification,the serum concentration of PQwas reduced significantly in the HP+CVVH group(P＜0.01),but not in the HP+HDF group (P＞0.05);the PQconcentration of urine was reduced significantly in both groups;PQreduction percentage of both serum and urine in HP+CVVH group was higher than that in HP+HDF group (P＜0.01).(5)The serum level of ALT,AST,SCr and BUN in HP+CVVH group on 7th day was lower than on 3rd day(P＜0.05).Conclusion Both blood purification methods can eliminate PQfrom blood,and reduce POconcentration of urine;the HP+CVVH method can eliminate PQmore efficiently and smoothly,avoiding its rebound.The present study provids detailed data for the treatment of acute PQpoisoning using HP+HDF and HP+CVVH technologies.关键词
百草枯中毒/血液灌流/血液透析滤过/连续性静脉-静脉血液滤过Key words
paraquat poisoning/hemoperfusion/hemodiafiltration/continuous veno-venous hemofiltration分类
医药卫生引用本文复制引用
赵爽,李新华,范淑玲,胡大勇,李昌斌,薛闻,彭艾..血液灌流并连续性肾脏替代治疗和透析滤过治疗百草枯中毒疗效研究[J].中国实用内科杂志,2017,37(7):621-625,5.基金项目
国家自然科学基金(81671897,81270136) （81671897,81270136）
