摘要
目的探究早期血液灌流对急性百草枯中毒患者血清肌酐(CREA)、尿酸(UA)、总胆红素(TBIL)及血清炎症因子水平的影响。方法 2015年7月至2020年7月本院收治急性百草枯中毒患者102例,非同期队列研究法分为对照组(采用综合救治方案治疗)、观察组(于对照组基础上联合早期血液灌流治疗)各51例。比较两组疗效,观察治疗前后肝肾功能指标[血清肌酐(CREA)、总胆红素(TBIL)、血清尿酸(UA)]、血清炎症因子[降钙素原(PCT)、超敏C反应蛋白(hs-CRP)]变化,随访两组7d病死率及治疗前后序贯器官衰竭评分(SOFA)。结果观察组治疗后总有效率明显高于对照组(P<0.05)。与同组治疗前比较,治疗后两组CREA、UA、TBIL、PCT、hs-CRP明显降低,且观察组低于对照组(P<0.05)。观察组7 d病死率明显于对照组(P<0.05),治疗后第2、3、4天观察组SOFA评分明显低于对照组(P<0.05)。结论早期血液灌流可有效提高急性百草枯中毒患者的临床治疗效果,对减轻肝肾功能损害和炎症因子水平、降低短期病死率和改善预后等方面有明显作用,或可作为急性百草枯中毒患者有效救治手段。
Objective To explore the effects of early hemoperfusion on serum levels of creatinine(CREA),uric acid(UA),total bilirubin(TBIL)and inflammatory factors in patients with acute paraquat poi⁃soning.Methods Between July 2015 and July 2020,102 patients with acute paraquat poisoning were select⁃ed and divided into the control group(comprehensive treatment plan)and the observation group(early hemoper⁃fusion based on the treatment of control group)by random number table method,51 cases in each group.Thera⁃peutic effects of the two groups were compared.Liver and kidney function indexes(CREA,TBIL,UA)and se⁃rum inflammatory factors[Procalcitonin(PCT),high sensitivity C⁃reactive protein(hsCRP)]in both groups were observed before and after treatment.The 7⁃day mortality rates and sequential organ failure assessment(SO⁃FA)scores of the two groups were recorded.Results The total response rate in the observation group was sig⁃nificantly higher than that in the control group(P<0.05).After treatment,CREA,UA,TBIL,PCT and hsCRP in both groups were significantly reduced,which were significantly lower in the observation group than in the control group(P<0.05).The 7⁃day mortality rate in the observation group was significantly lower than that in the control group(P<0.05),and the SOFA scores were significantly lower than those of the control group on the 2nd,3rd and 4th day after treatment(P<0.05).Conclusion Early hemoperfusion can effectively improve the clinical effects of treatment for patients with acute paraquat poisoning.It has a significant effect on reducing liv⁃er and kidney damage and inflammatory factor levels,reducing short⁃term mortality and improving prognosis.It is expected to be an effective treatment for patients with acute paraquat poisoning.
作者
焦文明
高永霞
胡德亮
JIAO Wenming;GAO Yongxia;HU Deliang(Emergency ICU,The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital,Nan-jing,Jiangsu,China,210029)
出处
《分子诊断与治疗杂志》
2020年第12期1732-1735,共4页
Journal of Molecular Diagnostics and Therapy
基金
江苏省自然科学基金(BK2018517)。
