[1]李　闯,刘建萍,郝同琴,等.血必净联合血液灌流治疗急性百草枯中毒疗效观察[J].新乡医学院学报,2016,33(2):120-122.[doi:10.7683/xxyxyxb.2016.02.010]
　LI Chuang,LIU Jian-ping,HAO Tong-qin,et al.Curative effect of Xuebijing combined with hemoperfusion in patients with paraquat poisoning[J].Journal of Xinxiang Medical University,2016,33(2):120-122.[doi:10.7683/xxyxyxb.2016.02.010]
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血必净联合血液灌流治疗急性百草枯中毒疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
33
期数:
2016年2
页码:
120-122
栏目:
临床研究
出版日期:
2016-02-05

文章信息/Info

Title:
Curative effect of Xuebijing combined with hemoperfusion in patients with paraquat poisoning
作者:
李　闯1; 刘建萍2; 郝同琴1; 张建新1; 牛丽丹1
（1.新乡医学院第一附属医院急诊科，河南　卫辉　453100；2.新乡医学院第三附属医院普外科，河南　新乡　453003）
Author(s):
LI Chuang1; LIU Jian-ping2; HAO Tong-qin1; ZHANG Jian-xin1; NIU Li-dan1
（1.Department of Emergency，the First Affiliated Hospital of Xinxiang Medical University，Weihui 453100，Henan Province，China；2.Department of Surgery，the Third Affiliated Hospital of Xinxiang Medical University，Xinxiang 453003，Henan Province，China）
关键词:
百草枯中毒; 血必净; 血液灌流; 肿瘤坏死因子-α; 白细胞介素-6
Keywords:
paraquat poisoning; Xuebijing; hemoperfusion; tumor necrosis factor-α; interleukin-6
分类号:
R595.4
DOI:
10.7683/xxyxyxb.2016.02.010
文献标志码:
A
摘要:
目的　探讨血必净注射液联合血液灌流治疗急性百草枯中毒的临床疗效。方法　回顾性分析2005年9月至2014年9月新乡医学院第一附属医院急诊科收治的40例中重型口服百草枯中毒患者的临床资料，其中12例患者给予常规治疗（常规治疗组），15例患者给予常规治疗及血液灌流（血液灌流组），13例患者在常规治疗及血液灌流基础上加用血必净治疗（联合治疗组）。选择同期体检健康者20例作为健康对照组。采用酶联免疫吸附法检测健康对照组体检时及百草枯中毒患者中毒4、24、96 h后血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平；高效液相色谱法检测百草枯中毒患者同期血清百草枯水平；比较治疗28 d 3组患者生存率。结果　与健康对照组比较，百草枯中毒患者中毒4 h后血清TNF-α及IL-6水平显著升高（P<0.01），随着时间延续，百草枯中毒患者血清TNF-α及IL-6水平均持续升高。联合治疗组患者各时间点血清TNF-α及IL-6水平均显著低于同期血液灌流组及常规治疗组（P<0.01）。3组中毒患者血清百草枯水平在中毒后24 h达高峰，中毒后96 h时较中毒24 h下降，仍高于中毒4 h，但3组中毒患者组间及中毒后各组不同时间点血清百草枯水平比较差异均无统计学意义（P>0.05）。百草枯中毒患者血清TNF-α与IL-6呈显著正相关（r=0.841，P>0.05），血清百草枯水平与TNF-α及IL-6水平无明显相关性（r=0.190、0.094，P>0.05）。联合治疗组患者治疗28 d生存率显著高于常规治疗组和血液灌流组（P<0.01）。结论　百草枯中毒患者血清TNF-α、IL-6水平持续进行性升高。血必净联合血液灌流治疗能显著抑制急性百草枯中毒患者TNF-α、IL-6的释放，提高患者生存率。
Abstract:
Objective　To investigate the curative effect of Xuebijing combined with hemoperfusion in patients with paraquat poisoning.Methods　The medical records of 40 patients with middle-heavy acute paraquat poisoning who were admitted to the Department of Emergency of the First Affiliated Hospital of Xinxiang Medical University from September 2005 to September 2014 were retrospectively reviewed.In the 40 cases of patients，12 cases underwent regular treatment（conventional treatment group），15 cases underwent regular treatment and hemoperfusion（hemoperfusion group） and 13 cases underwent regular treatment and hemoperfusion combined with Xuebijing（combined treatment group）.Twenty healthy people who had physical examination during the same period were selected as healthy control group.Enzyme linked immunosorbent assay was used to detect the serum level of tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6），and the high performance liquid chromatography was used to detect the serum level of paraquat at 4，24 and 96 h after admission.The 28-day survival rate was compared among the three groups.Results　The serum level of TNF-α and IL-6 in patients with paraquat poisoning increased significantly at 4 h after admission compared with the healthy control group(P<0.01)，and they were progressive increasing with the extension of time.The TNF-α and IL-6 levels in combined treatment group were significantly lower than those in conventional treatment group and hemoperfusion group（P<0.01）.The serum level of paraquat in the three poisoning groups was maintain in high level at 24 h after admission，and decreased at 96 h after admission which was higher than that at 4 h after admission.But there was no significant difference of serum paraquat level among the three poisoning groups or among the different time point in each group（P>0.05）.The TNF-α level had positive correlation with IL-6 level（r=0.841，P>0.05）.Both TNF-α and IL-6 had no significant association with the serum level of paraquat（r=0.190，0.094，P>0.01）.The 28-day survival rate in combined treatment group was significantly higher than that in the other two groups（P<0.01）.Conclusion　The serum level of TNF-α and IL-6 are progressive increasing in patients with paraquat poisoning.And the treatment of Xuebijing combined with hemoperfusion could inhibit the proinflammatory of TNF-α and IL-6，improve the patients′ survival rate.

参考文献/References:

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更新日期/Last Update: 2016-02-05