重复血液灌流对重度有机磷农药中毒患者的炎症因子的影响

目的探讨血液灌流治疗急性重度有机磷农药中毒的应用价值。方法选取急性重度有机磷农药中毒患者60例,分为灌流组(HP组)和非灌流组(非HP组),非HP组按常规予积极洗胃、导泻、催吐,并予阿托品及解磷定治疗。HP组在上述治疗基础上进行血液灌流治疗。观察全部病例的阿托品用量、病死率、胆碱酯酶活力恢复时间、住院时间、中间综合征发生率、昏迷时间及肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-10、IL-1β、高敏C反应蛋白(hs-CRP)水平的变化。结果HP组阿托品用量、胆碱酯酶活力恢复时间、住院时间、中间综合征发生率、昏迷时间、病死率低于非HP组(P<0.05或P<0.01)。HP组TNF-α、IL-6、IL-10、IL-1β、hs-CRP水平较对照组降低(P<0.05)。结论血液灌流可以清除重度有机磷农药中毒的部分炎症因子,对重度有机磷农药脏器损害有保护作用。

The effect of repeated hemoperfusion on the cytokines in treatment of the patients with acute severe organophosphorus pesticide poisoning

Objective To assess the efficacy of the hemoperfusion in the treatment of the patients with acute severe organophosphorus pesticide poisoning.Methods Sixty patients with acute severe organophosphorus pesticide poisoning were enrolled and divided into hemoperfusion group(HP group) and non-hemoperfusion group(non-HP group),the non-HP group only accepted traditional treatment including gastric lavage,catharsis,emetic,atropine and pralidoxime,HP group were treated with both HP and traditional treatment at the same time.Observe all the patient′ duration of the recovery of CHE activity,the incidence of intermediate syndrome(IMS),the cumulative dosages of atropine in the hospital,the mortality,the day in hospital,the time of coma and cytokine TNF-α、IL-6、IL-10、IL-1β、hs-CRP between HP-group and non-HP group.Results The HP groups′ duration of the recovery of CHE activity,the incidence of intermediate syndrome(IMS),the cumulative dosages of atropine in the hospital,the day in hospital,the time of coma,the mortality was lower than those of the Non-HP group.Cytokine TNF-α,IL-6,IL-10,IL-1β,hs-CRP of HP-group were lower than those of non-HP group(P<0.05 or P<0.01).Conclusion Hemoperfusion is effective in the treatment of acute severe organophosphorus pesticide poisoning.Hemoperfusion can clear up some cytokines and protect the organ injury caused by organophosphorus pesticide poisoning.