Suzuki K, Takasu N, Okabe T, Ishimatsu S, Ueda A, Tanaka S, Fukuda A, Arita S, Kohama A
Department of Emergency and Critical Care Medicine, Kawasaki Medical School, Kurashiki, Japan.
Hum Exp Toxicol. 1993 Jul;12(4):323-7. doi: 10.1177/096032719301200411.
The effect of aggressive haemoperfusion; i.e. haemoperfusion of 10 h or more during the first 24 h after ingestion, on the clinical course of paraquat poisoning was studied. Among 40 patients admitted within 15 h after ingestion of paraquat with an SIPP of less than 100 (h x micrograms ml-1), 21 received aggressive haemoperfusion and 19 received conventional haemoperfusion; i.e. haemoperfusion of less than 10 h during the same period. Survival rates of patients with severity between an SIPP of 100 and Proudfoot's curve in the two groups were compared by the log-rank test. Aggressive haemoperfusion did not improve the outcome but did improve the survival rates; that is, the number of patients surviving at particular points in time (P < 0.05). The length of haemoperfusion for the aggressive haemoperfusion group was longer than that for the conventional group on the first day (P < 0.001), but the difference was insignificant during the following two days. Neither the time from ingestion to haemoperfusion, urine volume from the first to third day, nor initial plasma-paraquat concentrations and SIPP were significant between groups. These findings imply that aggressive haemoperfusion reduces the severity of paraquat poisoning and elongates survival time. We, therefore, propose that the efficacy of more aggressive haemoperfusion, such as the 'continuous haemoperfusion' proposed by Okonek et al., should be further studied.
研究了积极血液灌流（即在摄入百草枯后的头24小时内进行10小时或更长时间的血液灌流）对百草枯中毒临床病程的影响。在摄入百草枯后15小时内入院、SIPP（摄入后24小时血浆百草枯浓度曲线下面积）小于100（小时×微克/毫升）的40例患者中，21例接受了积极血液灌流，19例接受了常规血液灌流，即在同一时期进行少于10小时的血液灌流。通过对数秩检验比较两组中SIPP在100至普劳德富特曲线之间的严重程度患者的生存率。积极血液灌流虽未改善结局，但确实提高了生存率，即在特定时间点存活的患者数量（P<0.05）。积极血液灌流组第一天的血液灌流时间长于常规组（P<0.001），但在接下来的两天中差异不显著。两组之间从摄入到血液灌流的时间、第一天至第三天的尿量、初始血浆百草枯浓度和SIPP均无显著差异。这些发现表明积极血液灌流可降低百草枯中毒的严重程度并延长生存时间。因此，我们建议应进一步研究更积极的血液灌流（如奥科内克等人提出的“持续血液灌流”）的疗效。
