血液灌流对老年急性重度有机磷中毒患者脏器的保护作用

Protection Efficacy of Hemoperfusion for Elderly Patients with Acute Severe Organophosphorus Poisoning

目的探讨血液灌流对老年急性重度有机磷中毒患者脏器的保护效果,为临床推广应用该方法提供依据。方法将某医院收治的老年重度有机磷中毒患者120例,按随机数字表法分为血液灌流组(灌流组)与常规药物治疗组(对照组)各60例。入院后2 h内与治疗后第3天,比较两组患者血肌酐(Scr)、胱抑素(Crs-C)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、血清肌酸激酶同工酶(CK-MB)、血清肌钙蛋白Ⅰ(cTnⅠ)、B型钠尿肽(BNP),神经元特异性烯醇化酶(NSE),血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)水平的变化情况。结果入院后2 h,2组患者血Scr、Crs-C、AST、ALT、CK-MB、cTnⅠ、BNP、NSE、PT、APTT水平比较差异无统计学意义(P>0.05);治疗后第3天,灌流组血Scr、Crs-C、AST、ALT、CK-MB、cTnⅠ、BNP、NSE、PT、APTT水平较对照组均明显降低,两组比较差异有统计学意义(P<0.01)。结论血液灌流可减轻有机磷中毒患者心脏、肝、肾及脑损伤程度,减轻血凝系统异常,对毒素吸收后继发的各脏器功能损伤有保护作用。

Objective To investigate the protective effect of hemoperfusion in senile patients with severe acute organo- phosphorus pesticide poisoning. Methods 120 elderly patients diagnosed with severe organophosphate poisoning according were e- venly and randomlydivided into blood perfusion group （ perfusion group） and conventional drug treatment group （ control group）. The changes of Crs-C, AST, ALT, CK-MB, cTnI, BNP, NSE, PT,APTT and Scr were compared between the two groups. Results Two hours after admission,there was no significant difference （P〉0.05）in levels of Crs-C ,AST,ALT, CK - MB ,cTnI, BNP,NSE, PT and APT between the two groups of patients. After three days of treatment, the levels ofScr, Crs-C, AST, ALT, CK-MB, cTnI, BNP, NSE, PT, and APTr in hemoperfusion group were lower than in control group （P〈0.05）. Conclusion Hemoperfusion can re- duce the damange of organophosphate poisoning to the heart, liver, kidney and brain of patients, alleviate abnormalities of the blood coagulation system and protect organs from secondary damage.