摘要
目的观察有机磷中毒患者血液灌流(HP)联合连续性静脉-静脉血液滤过(CVVH)对有机磷的清除及血清抵抗素、内脂素含量的影响。方法将120例有机磷中毒患者在常规对症治疗的基础上,分为常规治疗组30例;以及在常规治疗的基础上行活性炭HP联合CVVH治疗组30例(HP联合CVVH治疗组);HP组30例;CVVH治疗组30例;各组均在治疗0、12、24、48、72h时留取血样3ml。采用ELISA法检测患者循环中血清抵抗素、内脂素含量水平。结果各组有机磷中毒患者治疗前血清抵抗素和内脂素含量均明显高于正常对照组(P<0.01),且各组治疗前抵抗素和内脂素含量差异不存在统计学意义(P>0.05),经过72h治疗,各组患者抵抗素和内脂素水平均明显降低。常规治疗组经过72h治疗,血清抵抗素和内脂素水平降低缓慢(P<0.05);HP联合CVVH治疗组治疗后有机磷中毒患者血清抵抗素和内脂素含量逐渐降低,治疗48h后已显著低于治疗前(P<0.05),治疗72h后降低更为明显(P<0.01);CVVH和HP组治疗后有机磷中毒患者血清抵抗素和内脂素含量逐渐下降,治疗24h后已显著低于治疗前(P<0.05),但48h后又明显升高;治疗72h后下降缓慢。有机磷中毒患者抵抗素和内脂素浓度呈正相关(r=0.76,P<0.01)。结论 HP联合CVVH治疗可有效清除有机磷中毒患者血液中炎症因子抵抗素和内脂素,改善患者内皮细胞功能。同时血清抵抗素和内脂素的检测,为临床观察HP联合CVVH的治疗效果提供了新的监测指标。
Objective To study the effects of hemoperfusion（HP） and continuous venovenous hemofiltration（CVVH） treatment on serum resistin and visfatin in patients with acute orgnaophosphorus pesticides poisoning（AOPP） .Methods 120 patients with AOPP were randomly divided into conventional treatment group（30 cases） and sequential HP and continuous venovenous hemofiltration（HP ＆ CVVH group,30 cases）;CVVH group（30 cases）;HP group（30 cases） .CVVH group were treated with continuous blood purification for 72 hours besides conventional treatment.Serum levels of resistin and visfatin were determined with ELISA dynamically before treatment and 0,12,24,48 and 72 hours after the treatment.Results The level of serum resistin and visfatin in patients in two AOPP groups was significantly higher than that in control group（P 〈 0.01）,there was no correlation between the conventional treatment group and the CVVH group in the level of serum resistin and visfatin（P 〉 0.05）,after 72 hours of treatment,patients in each group were significantly lower serum resistin and visfatin.To lower serum resistin and visfatin levels slow in the conventional treatment group（P 〈 0.05）,and the gradual lowering of serum resistin and visfatin levels in the HP ＆ CVVH group,48 hours after treatment was significantly lower than before treatment（P 〈 0.05）,72 hours after treatment to reduce even more pronounced（P 〈 0.01） .In patients with AOPP,Serum levels of resistin correlated with visfatin（r = 0.76,P 〈 0.01） .Conclusions HP ＆ CVVH treatment could reducethe role of resistin and visfatin which is a inflammatory factor in the blood,improve the function of endothelial cells in patients,and the level of resistin and visfatin in circulation markedly decreased.The effects of serum resistin and visfatin on the permeability of endothelial cells gradually reduced.Serum resistin and visfatin testing for the observation of HP ＆ CVVH treatment provides a new monitoring indicators.
出处
《中华临床医师杂志（电子版）》
CAS
2010年第8期66-70,共5页
Chinese Journal of Clinicians(Electronic Edition)
关键词
血液灌注
血液滤过
中毒
有机磷化合物
抵抗素
烟酰胺磷酸核糖基转移酶
Hemoperfusion
Hemofiltration
Poisoning
Organophosphorus compounds
Resistin
Nicotinamide phosphoribosyltransferase
