血液灌流对百草枯急性中毒兔血药浓度及组织病理学的影响

Effects of hemoperfusion on plasma concentration and histopathological changes in paraquat poisoningrabbits

目的 观察百草枯（PQ）急性中毒日本大耳白兔血液灌流后血药浓度及组织病理学改变。方法16只日本大耳白兔随机分为PQ中毒组（8只）及血液灌流治疗组（8只），两组动物以PQ50mg／kg染毒，染毒后45min左右予血液灌流治疗，两组均在不同处理后0.5、1.0、1.5、2.0、3.0、6.0、12.0、24.0、48.0、72.0h取血检测血浆中PQ浓度；取不同处理后1、3、7d动物的肺、肝脏、肾组织，光学显微镜下观察组织病理学改变，同时观察动物的临床表现。结果治疗组动物的临床中毒表现比中毒组轻，每组均有6只动物存活至7d观察期满。与中毒组比较，治疗组1.0、1.5、2.0、3.0、6.0、12.0、24.0、48.0、72.0h的血浆中PQ浓度均明显降低，差异有统计学意义（P〈0.05，P〈0.01）。治疗组兔经HP治疗后的峰浓度、曲线下面积、半减期[分别为（5.01±0．15）μg/L、（54.03±5.31）mg·h^1·L^1（16.29±3026）h]均明显低于中毒组[分别为（11.97±0．75）μg/l（141.40±10.10）mg·h^1·L^1（31.16±9.85）h]．差异有统计学意义（P〈0.05）；治疗组兔经HP治疗后的表观分布容积和清除牢明显高于中毒组，差异均有统计学意义（P〈0．05）。光学显微镜观察下，中毒组兔肺、肝脏、肾组织均可见充血、水肿、细胞浸润等病理学改变，治疗组兔的组织病理学改变均明显减轻。与中毒组比较，治疗组l、3、7d的肺组织、肝组织及肾小管损伤病理积分均明显降低，差异有统计学意义（P〈O．05）。结论日本大耳白兔PQ急性中毒时毒物吸收快，毒性大，半减期长，早期血液灌流可有效清除血浆中毒物，减轻主要脏器的病理损害，可能有利于进一步治疗。

Objective To observe the effects of hemopeffusion on plasma concentration and histopatho- logical changes in paraquat （PQ） poisoning rabbits. Methods Sixteen rabbits were randomly divided into expo- sure group （PQ group, n=8） and hemoperfusion plus PQ exposure group （HPQ group, n=8）. HPQ group were giv- en hemoperfusion in 45 rain after exposure to PQ. The plasma PQ concentrations at 0.5, 1.0, 1.5, 2.0, 3.0, 6.0, 12. 0, 24.0, 48.0 and 72.0 hours after exposure were measure in 2 groups. The histopathological changes of lung, liver and kidney were examined, the behavior changes and the survival number of 7 days were observed. Results The poisoning symptoms of HPQ group were generally better than those of PQ group, in each group six animals survived for 7d. The plasma PQ concentrations at 1.0, 1.5, 2.0, 3.0, 6.0, 12.0, 24.0, 48.0, 72.0 h after exposure in HPQ group were significantly lower than those in PQ group （P〈0.05 or/9〈0.01 ）. In HPQ group, the plasma PQ peak concentra- tion [（5.01_＋0.15] txg/L], area under the curve [（54.03±5.31）mgand PQ half-life time [（16.29-＋3.26） hi after treatment of ttP were significantly lower than those [（11.97＋-0.75） Ixg/L, （141.40-＋10.10） mg-h ^-L-~ and （3 I. 16_＋9.85） h] in PQ group （P〈0.05）. The apparent volume of distribution and PQ clearance rate in HPQ group were significantly higher than those in PQ group （P〈0.05）. Congestion, edema, cell infiltration and other patholog- ical changes were found in lung, liver and kidney in PQ group under the light microscope, which were signifieautly more severe than those in HPQ group. The pathologic scores of lung tissue, liver and renal tubular damage on the I st, 3rd, 7th days after exposure in HPQ group were signifieantly lower than those in PQ group （P〈0.05）. Conclusion When acute PQ poising, rabbits appeared the quick absorption, high toxicity and long half-life time of PQ. The early hemoperfusion can effectively remove the toxicant in plasma and reduce the pathological injury in major organs, which may be beneficial for further treatment.