血、尿百草枯浓度对其急性中毒患者预后的影响

目的探讨急性百草枯巾毒患者行血液灌流（HP）治疗前后血及尿药物浓度对预后的影响。方法测定69例行HP治疗的百草枯巾毒患者治疗前后血及尿药物浓度，分析其与患者预后的关系。结果69例患者死亡39例，1年存活3【）例，1年生存率43．5％，存4h内行HP的患者HP前血及尿药物浓度越低，生存率越高，HP前血药物浓度在5．6mg／L以上者不论就医时间长短及采取何种治疗措施均死亡，HP前血药浓度≤1．8mg／L者均存活，尿药物浓度≤77．4mg／L的患者4h内行HP可提高生存率，超过4h行HP可延长生存时间但不能提高生存率，4h内行HP的患者服药距HP时间、HP前血及尿百草枯药物浓度是影响百草枯中毒患者生存率的3个主要因素。结论HP能有效清除体内百草枯，HP治疗前血及尿百草枯药物浓度与患者生存率密切相关。

Effect of plasma and urine level of paraquat on prognosis of patients with paraquat poisoning

Objective To study the effect of plasma and urine level of paraquat （PQ） on the prognosis. Methods Measuring the plasma and urine level of PQ before and after haemoperfusion （HP） in 69 paticnts with paraquat poisoning, analyse the relationship between the plasma and urine level of PQ and the prognosis of patients. Results Among 69 patients,39 were dead,30 survived, the survival rates of patients in one year is 43.5%. For patients who accepted HP in 4 hours, the plasma and urine level of PQ before HP of the survivors group was significantly lower than those of the non-survivors group. Among the nonsurvivors, the lower the plasma and urine level of PQ, the longer the survival time. The patients whose plasma level of PQ was higher than 5.6mg/L or urine level of PQ was higher than 77.4mg/L before HP were dead. HP within 4 hours could improve the survival rate and HP after 4 hours could not improve the survival rates although it could elongate survival time. All the patients whose plasma level of PQ was lower than 1.8mg/L and received HP in 4 hours survived. Time of HP,plasma and urine level of paraquat before Hp were the three main factors related to the prognosis of paraquat poisoning. Conclusions Adequate HP was one of the effective treatments for patients with acute PQ piosioning. The plasma and urine level of PQ before HP may be the main factor related to the survival rate and survival time.