摘要
目的:探讨HA230、HA330树脂血液灌流器串联救治百草枯中毒的疗效,了解血液灌流清除炎症介质和百草枯的能力。方法:选择口服百草枯中毒病人56例。在常规治疗百草枯中毒基础上分为:A组,HA230树脂血液灌流器治疗百草中毒35例;B组,HA230、 HA330树脂血液灌流器串联治疗百草枯中毒21例;监测2组病人第一次血液灌流前后血浆百草枯浓度,收集并分析性别、年龄、服毒至第一次血液灌流时间、百草枯中毒严重指数、肝肾心肌损伤时间及血常规各指标与预后的关系,评价2种不同血液净化方式的疗效。监测2组灌流前后百草枯浓度、人血清白细胞介素6(IL-6)含量、谷胱甘肽过氧化物酶(GSH-PX)活力、丙二醛(MDA)含量、超氧化物歧化酶(SOD)活力的变化,探讨百草枯中毒病人MODS的发病机制及清除炎症介质和百草枯的能力。结果:56例百草枯中毒病人病死率为48%(27例),2组灌流前后百草枯浓度差异有统计学意义(P<0.05);A组组内灌流前后SOD活力差异有统计学意义(P<0.01),A组组内灌流前后GSH-PX活力、MDA含量、IL-6含量差异均无统计学意义(P>0.05);B组组内灌流前后SOD活力、GSH-PX活力、MDA含量、IL-6含量差异均无统计学意义(P>0.05);A、B 2组灌流前后SOD活力、GSH-PX活力、MDA含量、IL-6含量差异均无统计学意义(P>0.05);A组灌流前、后IL-6含量、GSH-PX活力、MDA含量、SOD活力与百草枯浓度均无明显相关性。结论:血液灌流能有效清除百草枯;HA230、HA330树脂血液灌流器串联与单用HA230树脂血液灌流器治疗百草枯中毒未见明显疗效差异。
Objective:To discuss the effects of the tandem of HA230 and HA330 in the treatment of paraquat poisoning,and know the hemoperfusion removing inflammatory mediators and paraquat capacities.Methods:Fifty-six patients with oral paraquat poisoning were divided into the group A(35 cases)and group B(21 cases),and the group A and group B were treated with HA230 resin hemoperfusion and tandem of HA230 and HA330,respecively.Before and after the first hemoperfusion in two groups,the paraquat concentration were monitored,the data of gender,age,poisoning to the first hemoperfusion time,paraquat poisoning severityindex,liver and kidney and myocardial injury time and blood routine were collected and anllyzed,the relationship between above indictors with prognosis were investagyed,and the clinical efficicay of two kinds of treatments were assessd.The paraquat concentration,human serum interleukin 6(IL-6)content,human serum glutathione peroxidase(GSH-PX)activity,human serum malondialdehyde(MDA)content and serum superoxide dismutase(SOD)activity in two groups before and after perfusion were monitored,and the pathogenesis of MODS in patients with paraquat poisoning,and the abilities to remove inflammatory mediators and paraquat were investigated.Results:The fatality rate in 56 patients with paraquat poisoning was 48%(27 cases).The differences of the paraquat concentration in two groups between before and after perfusion were statistically significant(P<0.05).The difference of the SOD activity in group A between before and after perfusion was statistically significant(P<0.01),and the differences of the GSH-PX activity,MDA content and IL-6 content in group A before and after perfusion were not statistically significant(P>0.05).The differences of the SOD activity,GSH-PX activity,MDA content and IL-6 contentin in group B between before and after perfusion were not statistically significant(P>0.05).The differences of the SOD activity,GSH-PX activity,MDA content and IL-6 content in two groups between before and after perfusion were not
作者
王冉
吴晓飞
潘柳华
WANG Ran;WU Xiao-fei;PAN Liu-hua(Department of Emergency Medicine,The First Affiliated Hospital of Bengbu Medical College,Bnegbu Anhui 233004,China)
出处
《蚌埠医学院学报》
CAS
2020年第12期1627-1631,共5页
Journal of Bengbu Medical College
基金
蚌埠医学院科技发展基金面上项目(ByKf BA26)。
