HP辅助治疗急性PQ中毒患者的血清PQ清除率及治疗效果分析

Analysis of serum PQ clearance rate and therapeutic effect of HP adjuvant therapy in patients with acute PQ poisoning

目的：探讨采用血液灌流（HP）治疗急性百草枯（PQ）中毒患者的对血清PQ清除率及临床效果的影响。方法：选取我院2011-2015年收治的87例PQ中毒患者进行回顾性分析,根据HP治疗方法分为常规组47例（洗胃＋1次HP治疗＋常规治疗）和强化组40例[洗胃＋3次HP治疗（间隔时间6h）＋常规治疗],分别检测HP治疗前、HP后即刻、8h、16h、24h两组患者血清PQ水平,并比较两组患者不同时间点的血清丙二醛（MDA）、超氧化物歧化酶（SOD）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）的差异,并比较2组患者的救治成功率。结果：强化组治疗后8h、16h、24h的血清PQ水平均显著的低于常规组患者（P〈0.05）;强化组和常规组第1次PQ清除率差异无统计学意义,第2次、第3次HP治疗强化组的PQ清除率分别为（35.9±6.11）%和（28.85±4.70）%;强化组治疗后24h、72h的血清MDA、IL-10、TNF-α、PaCO2、BUN、Cr水平均显著的低于常规组患者（P〈0.05）,SOD、PaO_2水平在治疗后24h、72h显著的高于常规组患者（P〈0.05）;强化组的救治成功率50.00%显著的高于常规组的27.66%（P〈0.05）。结论：急性PQ中毒患者及时多次应用HP治疗有利于提高患者的救治成功率。

Objective：To investigate the effect of blood perfusion（HP）on serum PQ clearance and clinical effect in patients with acute paraquat（PQ）poisoning.Method：87cases of PQ poisoning patients admitted in hospital from 2011~2015were retrospectively analyzed.According to the HP therapy,the patients were divided into routine group（47cases,gastric lavage＋1HP therapy plus routine treatment）,strengthen group[40cases,gastric lavage＋3HP treatment（interval time 6h）plus conventional therapy].Before the treatment,HP were applied immediately,8h,16 h,24hin the two groups.The difference of serum malondialdehyde（MDA）,superoxide dismutase（SOD）,leukocyte mediated IL-10（IL-10）,tumor necrosis factor alpha（TNF alpha）were detected at different time points and compared between the two groups of patients with treatment success rate.Result：The PQ serum levels were significantly lower than conventional group patients（P〈0.05）in intensive group therapy after8 h,16hand 24 h.The first PQ clearance rate shows no significant difference in intensive group and the conventional group.The PQ clearance rate in HP strengthen treatment group at second and third was（35.9±6.11）%and（28.85±4.70）%respectively.The serum levels of MDA,IL-10,TNF-α,PaCO2,BUN,Cr in strengthen group at 24 hand 72hwere significantly lower than the conventional group patients（P〈0.05）.The SOD,PaO_2 levels after treatment 24 h,72hwas significantly higher than the conventional group patients（P〈0.05）.The treatment success rate in strengthen group was 50.00%,which was significantly higher than the conventional group of27.66%（P〈0.05）.Conclusion：HP applications timely will help improve the success rate of PQ poisoning patient.