天津医药

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血液灌流对重度有机磷中毒患者的胆碱酯酶和炎性细胞因子的影响

高宝安,陈世雄,向光明,官莉,阮玉姝,张婷婷   

  1. 三峡大学第一临床医学院-宜昌市中心人民医院
  • 收稿日期:2011-11-21 修回日期:2012-05-15 出版日期:2012-12-15 发布日期:2012-12-15
  • 通讯作者: 高宝安

Effects of hemoperfusion on cholinesterase activity and inflammatory mediators in patients with severe acute organic phosphorus poisoning

  • Received:2011-11-21 Revised:2012-05-15 Published:2012-12-15 Online:2012-12-15

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摘要： 摘 要 目的 观察血液灌流对重度有机磷中毒患者胆碱酯酶和炎性细胞因子的影响。方法 比较55例接受常规治疗的重度有机磷中毒患者（对照组）和55例在常规治疗基础上早期加以血液灌流治疗患者（灌流组）的胆碱酯酶、胆碱酯酶恢复时间、APACHEⅡ评分、炎性细胞因子、住院时间、阿托品用量、死亡率等指标。结果 灌流组患者APACHEⅡ评分、胆碱酯酶恢复时间、住院时间、阿托品用量、死亡率显著低于对照组（P均<0.05），灌流组治疗3天后胆碱酯酶显著高于对照组（P<0.05）；灌流组患者治疗3天后血清肿瘤坏死因子-α、白细胞介素-6、超敏C反应蛋白较治疗前显著降低（P均<0.01）。结论 早期血液灌流可通过降低炎性细胞因子而有效改善重度有机磷中毒患者的预后。

关键词: 血液灌流, 有机磷中毒, 炎性细胞因子, 胆碱酯酶

Abstract: Abstract Objective To investigate effects of hemoperfusion on cholinesterase activity and inflammatory mediators in patients with severe acute organic phosphorus poisoning. Methods Cholinesterase activity, recovering time of cholinesterase, APACHEⅡ scores, inflammatory mediators, hospitalization time, cumulative dosage of atropine, mortality rate were measured in 55 patients treated with routine treatment (control group) and 55 patients treatd with hemoperfusion based on routine treatment (hemoperfusion group). Results Compared with control group, , APACHEⅡ scores, recovering time of cholinesterase, hospitalization time, cumulative dosage of atropine, mortality rate in hemoperfusion group were significantly reduced(P all <0.05), while cholinesterase activity in hemoperfusion group were significantly increased in the third day after hemoperfusion treatment (P<0.05). Serum tumor necrosis factor-α( TNF-α), interleukin-6, high-sensitivity C-reactive protein (hs-CRP) of patients in hemoperfusion group were significantly reduced after 3 days with hemoperfusion (P all <0.01). Conclusions Early hemoperfusion may improve prognosis via reducing inflammatory mediators in patients with severe acute organic phosphorus poisoning.

Key words: Hemoperfusion, Organic phosphorus poisoning, Inflammatory mediators, Cholinesterase