Hampson E C, Pond S M
University of Queensland Department of Medicine, Princess Alexandra Hospital, Brisbane.
Med Toxicol Adverse Drug Exp. 1988 Jan-Dec;3(1):64-71. doi: 10.1007/BF03259932.
In this review the efficacy of haemoperfusion in the treatment of paraquat poisoning is addressed. 42 reports containing sufficient information of paraquat-poisoned patients were evaluated. These reports, from 35 patients reported in the literature and 7 new cases, were chosen for the following reasons: the timed plasma paraquat concentrations were known, patient outcome was known, and details of haemoperfusion were available. In some cases, haemodialysis was also performed. The plasma paraquat concentrations and the specific times post-ingestion were plotted on a contour graph that predicts the probability of survival. Comparison of the predicted probability of survival versus the actual outcome showed that haemoperfusion, single or repeated, did not affect patient survival. None of the patients whose initial plasma concentrations were greater than 3 mg/L paraquat survived, regardless of the time after ingestion that the concentrations were measured, and despite haemoperfusion. Therefore, such patients might not be considered for haemoperfusion because of their uniformly bad prognosis, despite the procedure being used, and because of the morbidity, discomfort and cost associated with it. Clearly, the need for better techniques to remove paraquat and to prevent the consequences of the metabolic effects of the compound are required urgently before the treatment of the paraquat-poisoned patient will be successful.
本综述探讨了血液灌流治疗百草枯中毒的疗效。对42份包含足够百草枯中毒患者信息的报告进行了评估。这些报告来自文献报道的35例患者和7例新病例，选择这些报告的原因如下：已知血浆百草枯的定时浓度、患者的预后情况以及血液灌流的详细信息。在某些情况下，还进行了血液透析。将血浆百草枯浓度和摄入后的特定时间绘制在预测生存概率的等高线图上。预测生存概率与实际结果的比较表明，单次或重复血液灌流均不影响患者的生存。无论摄入后测量浓度的时间如何，初始血浆浓度大于3mg/L百草枯的患者无一存活，尽管进行了血液灌流。因此，尽管采用了该治疗方法，但由于这类患者预后普遍较差，且该治疗存在发病率、不适感和成本等问题，可能不考虑对其进行血液灌流。显然，在成功治疗百草枯中毒患者之前，迫切需要更好的技术来清除百草枯并预防该化合物代谢效应的后果。
