Effect of haemoperfusion on plasma paraquat concentration in vitro and in vivo
Effect of haemoperfusion on plasma paraquat concentration in vitro and in vivo
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DOI：
10.1191/0748233703th171oa
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发表时间：
2003-01-01
影响因子：
1.9
通讯作者：
Kim, SH
中科院分区：
文献类型：
--
作者：
Hong, SY;Yang, JO;Kim, SH
本研究观察人数较多的组血液灌流（HP）后百草枯（PQ）的减少率：105例急性PQ中毒患者中有50例存活。我们首先测量了PQ的血液透析（HD）和HP体外清除率。在血流量为250 mL/min时，前90分钟内HP的PQ清除率大于HD：30分钟时为215与175 mL/min，60分钟时为213与201 mL/min，90分钟时为199与179 mL/min。HP清除率在2小时后迅速下降。然而，在透析结束时，容器中的最终浓度在HD中降至5.7 mg/mL，在HP中降至1.5 mg/mL，这意味着尽管HD在后期阶段被更有效地清除，但在HP中的总体消除更大。在初步研究后，我们对所有患者进行了HP，以评估体外消除情况。105名吞咽1 - 3口PQ（24.5% w/v）溶液的患者接受了体内研究。通过测定HP前、后4 h血浆中PQ的浓度来检测PQ的降低率。存活组的减毒率明显高于死亡组（80.3 +/-19.9vs67.2 +/-19.2%，P< 0.01），因此我们认为，对急性PQ中毒患者进行充分的HP治疗是不可或缺的。
This study was to observe the paraquat (PQ) reduction rate after haemoperfusion ( HP) on the groups of a relatively large number: 50 survivors out of 105 patients with acute PQ poisoning. We started off by measuring the clearance of haemodialysis (HD) and HP for the PQ in vitro. At the blood flow of 250 mL/min, the PQ clearance was greater in HP than in HD during the first 90 minutes: 215 versus 175 mL/min at 30 minutes, 213 versus 201 mL/min at 60 minutes, and 199 versus 179 mL/min at 90 minutes. The clearance in HP decreased rapidly after two hours. By the end of the dialysis, however, the final concentration in container decreased to 5.7 mg/mL in HD and 1.5 mg/mL in HP, which implied that although HD was cleared more effectively during the later stages, the overall elimination was greater in HP. Following this preliminary investigation, we performed HP on all the patients in order to assess the extracorporeal elimination.One hundred and five patients who had swallowed one to three mouthfuls of PQ ( 24.5% w/v) solution were subjected to the in vivo study. The reduction rate of PQ was checked out by measuring the PQ concentration in plasma before and after four hours of HP. Seeing the reduction rate was significantly higher in the survivors group than in the nonsurvivors group (80.3 +/- 19.9 versus 67.2 +/- 19.2%, P< 0.01), we concluded that adequate HP appears to be an indispensable treatment for patients with acute PQ poisoning.