Emergency Department of Harrison International Peace Hospital Affiliated to Hebei Medical University, China.
J Toxicol Sci. 2020;45(10):611-617. doi: 10.2131/jts.45.611.
Acute paraquat poisoning (APP) is a serious public health problem with a high mortality rate and there is no specific antidote for APP in clinical. Early haemoperfusion (HP) treatment is effective in APP rescue. In this study, we compared the influence of routine HP and continuous HP on the survival rate and the treatment of pulmonary fibrosis in mild and moderate APP patients. Eighty-two cases of mild and moderate APP patients who were admitted to our hospital from January of 2017 to December of 2018 were selected. All patients were randomly divided into a routine haemoperfusion (HP) group (n = 40) and a continuous haemoperfusion (CHP) group (n = 42). Compared with the HP group, the 28-day survival rate of mild and moderate APP patients was elevated in the CHP group. Blood N-terminal procollagen Ш propeptide (PIIINP) levels in APP patients were positively related with paraquat (PQ) concentration (r = 0.309, P = 0.000). There were statistically significant differences in the levels of PIIINP, Collage TypeIV (CIV), transforming growth factor-beta 1 (TGF-β1), malondialdehyde (MDA), superoxide dismutase (SOD) activity and sequential organ failure assessment (SOFA) score between the two groups both on the third and seventh days after treatment, and the treatment effect of the CHP group on pulmonary fibrosis in APP patients was better than that of the HP group. In conclusion, CHP treatment had a significant therapeutic effect on mild and moderate APP patients, which could effectively improve the survival rate and relieve pulmonary fibrosis.
急性百草枯中毒(APP)是一个严重的公共卫生问题,死亡率高,临床上没有针对 APP 的特效解毒剂。早期血液灌流(HP)治疗对 APP 抢救有效。本研究比较了常规 HP 和连续 HP 对轻中度 APP 患者生存率和肺纤维化治疗的影响。选择 2017 年 1 月至 2018 年 12 月我院收治的 82 例轻中度 APP 患者,所有患者随机分为常规血液灌流(HP)组(n=40)和连续血液灌流(CHP)组(n=42)。与 HP 组相比,CHP 组轻中度 APP 患者 28 天生存率升高。APP 患者血 N 末端前胶原Ш 前肽(PIIINP)水平与百草枯(PQ)浓度呈正相关(r=0.309,P=0.000)。治疗后第 3、7 天,两组患者的 PIIINP、胶原 IV(CIV)、转化生长因子-β1(TGF-β1)、丙二醛(MDA)、超氧化物歧化酶(SOD)活性和序贯器官衰竭评估(SOFA)评分均有统计学差异,CHP 组对 APP 患者肺纤维化的治疗效果优于 HP 组。结论:CHP 治疗对轻中度 APP 患者有显著的治疗效果,可有效提高生存率,缓解肺纤维化。