Department of Emergency Medicine, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China.
Sci Rep. 2017 May 22;7(1):2239. doi: 10.1038/s41598-017-02527-0.
Early haemoperfusion (HP) therapy has been found to be very effective in acute paraquat (PQ) poisoning, but the effective rescue window is still uncertain. Demographic data and the type of therapies administered of 621 patients were included as confounding factors in this retrospective study. After receiver operating characteristic curve analysis and intra-group/subgroup analysis, the initiation of glucocorticoid therapy within 3 hrs of exposure with a second treatment given <21 hrs after exposure, HP initiated within 4 hrs of exposure with a second treatment given <20 hrs after exposure, the appearance of pulmonary lesions ≤8 days after exposure and six other variables were used in a multiple analysis. The strength of positivity of the PQ urine test on admission, HP initiated within 4 hrs of exposure with a second treatment given <20 hrs after exposure, the appearance of pulmonary lesions ≤8 days after exposure, and stage III AKI on admission were independent factors of survival probability. HP therapy for acute PQ poisoning was the main therapeutic intervention investigated in this study. Outcomes were time dependent, and the crucial factor was the initiation of therapy within 4 hrs of PQ poisoning followed by a second treatment within 20 hrs.
早期血液灌流（HP）治疗已被发现对急性百草枯（PQ）中毒非常有效，但有效的抢救窗口期仍不确定。本回顾性研究将人口统计学数据和所给予的治疗类型作为混杂因素纳入。经过受试者工作特征曲线分析和组内/亚组分析，暴露后 3 小时内开始使用糖皮质激素治疗，第二次治疗在暴露后 21 小时内给予，暴露后 4 小时内开始 HP 治疗，第二次治疗在暴露后 20 小时内给予，肺损伤出现≤8 天，以及其他 6 个变量用于多因素分析。入院时 PQ 尿检测阳性强度、暴露后 4 小时内开始 HP 治疗，第二次治疗在暴露后 20 小时内给予、≤8 天出现肺部病变和入院时 III 期 AKI 是生存概率的独立因素。本研究主要研究了急性 PQ 中毒的 HP 治疗。结果是时间依赖性的，关键因素是在 PQ 中毒后 4 小时内开始治疗，然后在 20 小时内进行第二次治疗。
