The value of plasma paraquat concentration in predicting therapeutic effects of haemoperfusion in patients with acute paraquat poisoning.
The value of plasma paraquat concentration in predicting therapeutic effects of haemoperfusion in patients with acute paraquat poisoning.
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血浆百草枯浓度对急性百草枯中毒患者血液灌流疗效的预测价值
DOI：
10.1371/journal.pone.0040911
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Wang L
中科院分区：
文献类型：
--
作者：
Shi Y;Bai Y;Zou Y;Cai B;Liu F;Fu P;Wang L
目的分析血液灌流对血浆百草枯（PQ）的清除作用，评价PQ检测在急性百草枯中毒救治中的临床意义。方法2010年6月至2011年3月，华西医院收治急性口服百草枯中毒患者85例。对所有受试者给予标准化治疗方案，包括紧急血液灌流。在血液灌流治疗前（0小时）、进行中（血液灌流开始后1小时）和结束时（2小时）共采集91份全血样本。计算清除率并分析相关因素。结果随着血液灌流的进行，患者血浆百草枯浓度持续下降。血液灌流1h后，平均清除率（R1）为37.06± 21.81%。血液灌流2小时后，平均清除率（R2）为45.99± 23.13%。R1/R2比值平均为76.61± 22.80%。百草枯高浓度组（血浆百草枯浓度（C 0）>300 ng/mL）R1和R2均值均显著高于百草枯低浓度组（C 0 ≤200 ng/mL）（p<0.05），两组R1/R2差异无显著性（p>0.05）。结论PQ急性中毒患者血浆PQ浓度的动态监测不仅对临床病情的判断有重要意义，而且对指导临床治疗有重要意义。血液灌流可有效清除高PQ浓度患者血浆中的百草枯，而对低PQ浓度（<200 ng/ml）患者，血液灌流清除效果非常有限。增加HP治疗时间可提高HP对血浆PQ的总清除率，但降低HP清除效率，而重复HP治疗有助于对抗反跳现象。
Objective This study was aimed to analyze the scavenging effect of haemoperfusion on plasma paraquat (PQ) and to evaluate the clinical significance of PQ examination in the treatment of patients with acute paraquat poisoning. Methods 85 patients with acute paraquat intoxication by oral ingestion were admitted in West China Hospital from Jun, 2010 to Mar, 2011. A standardized therapeutic regimen including emergency haemoperfusion was given on all subjects. A total of 91 whole blood samples were taken before (0h), underway (1h after haemoperfusion beginning) and at the end (2h) of the haemoperfusion therapy. The clearance rate was calculated and related factors were analyzed. Results As heamoperfusion was going on, the plasma paraquat concentration of the patients kept falling down. After 1 hour of haemoperfusion, the average clearance rate (R1) was 37.06±21.81%. After 2 hours of haemoperfusion, the average clearance rate (R2) was 45.99±23.13%. The average of R1/R2 ratio was 76.61±22.80%. In the high paraquat concentration group (plasma paraquat concentration (C0) >300 ng/mL), both the averages of R1 and R2 were significantly higher than those of the low paraquat concentration group (C0≤200 ng/mL) (p<0.05), and there was no significant difference of R1/R2 between these two groups (p>0.05). Conclusions The dynamic monitoring of plasma PQ concentration was not only critical in the clinical evaluation but also helpful in guiding the treatment of patients with acute PQ intoxication. Haemoperfusion can effectively eliminate paraquat from the plasma in patients with high initial plasma PQ concentration, while in patients with low initial plasma PQ concentration (<200 ng/ml), the clearance effect of harmoperfusion was very limited. Increasing HP time might improve the overall clearance rate of HP on plasma PQ yet decrease the elimination efficiency of HP, while repeated HP treatment was helpful against the rebound phenomena.
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影响因子：
4.5
作者：
Kang, Moon-Soo;Gil, Hyo-Wook;Yang, Jong-Oh;Lee, Eun-Young;Hong, Sae-Yong
通讯作者：
Hong, Sae-Yong
影响因子：
3.3
作者：
Gil, Hyo-Wook;Kang, Mun-Soo;Hong, Sae-Yong
通讯作者：
Hong, Sae-Yong
影响因子：
1.9
作者：
Hong, SY;Yang, JO;Kim, SH
通讯作者：
Kim, SH
DOI：
10.1081/clt-100100926
发表时间：
2000-01-01
期刊：
JOURNAL OF TOXICOLOGY-CLINICAL TOXICOLOGY
影响因子：
--
作者：
Jones, GM;Vale, JA
通讯作者：
Vale, JA
影响因子：
1.9
作者：
Lee, EY;Kwang, KY;Hong, SY
通讯作者：
Hong, SY