中国急救医学
中國急救醫學
중국급구의학
Chinese Journal of Critical Care Medicine
2015年
11期
1009-1012
,共4页
刘海波%郁映晴%郑福鸿%王瑞
劉海波%鬱映晴%鄭福鴻%王瑞
류해파%욱영청%정복홍%왕서
依达拉奉%血液灌流(HP)%百草枯(PQ)%多器官功能损伤
依達拉奉%血液灌流(HP)%百草枯(PQ)%多器官功能損傷
의체랍봉%혈액관류(HP)%백초고(PQ)%다기관공능손상
Edaravone%Hemoperfusion(HP)%Paraquat(PQ)%Multiple organ injuries
目的 探讨依达拉奉联合血液灌流( HP)对百草枯( PQ)中毒致多器官功能损伤的脏器保护及治疗作用. 方法 采用前瞻性研究方法,将60例百草枯中毒患者随机分为依达拉奉联合血液灌流治疗组( A组,30例)和对照组( B组,单纯血液灌流组,30例). 于血液灌流后第1、3、7及14天分别检测患者血氧饱和度( SaO2 )、肝肾功能和心肌酶学指标;同时检测血清丙二醛( MDA)、超氧化物歧化酶( SOD);采用ELISA法测定血清肿瘤坏死因子-α( TNF-α)及白细胞介素-10(IL-10)的水平. 结果 ①治疗组患者病死率低于对照组(P<0.05). ②两组患者血CK-MB、ALT、AST、Cr水平均有不同程度改变,但治疗组各项指标在第3、7天明显优于对照组(P<0.05). ③两组患者血浆MDA水平均有升高,于第3天达到峰值;SOD水平于第1天明显下降,然后逐渐升高,至第14天,治疗组基本恢复正常,对照组仍低于正常( P<0.05);治疗组MDA水平低于对照组,SOD水平高于对照组. ④两组患者血清TNF-α及IL-10水平均明显升高,于第3天达到峰值,对照组升高更加明显( P<0.05). 结论 依达拉奉联合血液灌流可以通过清除自由基及调控炎症反应,对百草枯中毒有很好的保护作用,从而达到脏器保护作用,并进一步降低病死率.
目的 探討依達拉奉聯閤血液灌流( HP)對百草枯( PQ)中毒緻多器官功能損傷的髒器保護及治療作用. 方法 採用前瞻性研究方法,將60例百草枯中毒患者隨機分為依達拉奉聯閤血液灌流治療組( A組,30例)和對照組( B組,單純血液灌流組,30例). 于血液灌流後第1、3、7及14天分彆檢測患者血氧飽和度( SaO2 )、肝腎功能和心肌酶學指標;同時檢測血清丙二醛( MDA)、超氧化物歧化酶( SOD);採用ELISA法測定血清腫瘤壞死因子-α( TNF-α)及白細胞介素-10(IL-10)的水平. 結果 ①治療組患者病死率低于對照組(P<0.05). ②兩組患者血CK-MB、ALT、AST、Cr水平均有不同程度改變,但治療組各項指標在第3、7天明顯優于對照組(P<0.05). ③兩組患者血漿MDA水平均有升高,于第3天達到峰值;SOD水平于第1天明顯下降,然後逐漸升高,至第14天,治療組基本恢複正常,對照組仍低于正常( P<0.05);治療組MDA水平低于對照組,SOD水平高于對照組. ④兩組患者血清TNF-α及IL-10水平均明顯升高,于第3天達到峰值,對照組升高更加明顯( P<0.05). 結論 依達拉奉聯閤血液灌流可以通過清除自由基及調控炎癥反應,對百草枯中毒有很好的保護作用,從而達到髒器保護作用,併進一步降低病死率.
목적 탐토의체랍봉연합혈액관류( HP)대백초고( PQ)중독치다기관공능손상적장기보호급치료작용. 방법 채용전첨성연구방법,장60례백초고중독환자수궤분위의체랍봉연합혈액관류치료조( A조,30례)화대조조( B조,단순혈액관류조,30례). 우혈액관류후제1、3、7급14천분별검측환자혈양포화도( SaO2 )、간신공능화심기매학지표;동시검측혈청병이철( MDA)、초양화물기화매( SOD);채용ELISA법측정혈청종류배사인자-α( TNF-α)급백세포개소-10(IL-10)적수평. 결과 ①치료조환자병사솔저우대조조(P<0.05). ②량조환자혈CK-MB、ALT、AST、Cr수평균유불동정도개변,단치료조각항지표재제3、7천명현우우대조조(P<0.05). ③량조환자혈장MDA수평균유승고,우제3천체도봉치;SOD수평우제1천명현하강,연후축점승고,지제14천,치료조기본회복정상,대조조잉저우정상( P<0.05);치료조MDA수평저우대조조,SOD수평고우대조조. ④량조환자혈청TNF-α급IL-10수평균명현승고,우제3천체도봉치,대조조승고경가명현( P<0.05). 결론 의체랍봉연합혈액관류가이통과청제자유기급조공염증반응,대백초고중독유흔호적보호작용,종이체도장기보호작용,병진일보강저병사솔.
Objective To discuss the prevention and treatment effect of edaravone combined with hemoperfusion technology on multiple organ injuries caused by paraquat poisoning .Methods By means of prospective study , 60 cases of paraquat poisoning patients were randomly divided into edaravone combined with hemoperfusion in the treatment group (group A with 30 cases) and the control group ( group B with 30 cases ) .We detected respectively oxygen saturation ( SaO2 ) , renal function , liver function and myocardial enzyme indexes on the 1 d, 7 d, 3 d, 14 d, as while as detected malondialdehyde ( MDA ) , superoxide dismutase ( SOD ) , and the content tumor necrosis factor -α( TNF-α) and interleukin -10 ( IL-10 ) in serum by ELISA .Results ①The mortality of the two groups were compared, the treatment group was lower than the control group (P<0.05).②The level of ALT, AST, CK-MB, Cr of both groups have different degrees of change , furthermore the data in group A on 7 d, 3 d were significantly better than those in group B (P<0.05).③The plasma MDA levels were elevated in both groups , and reached the peak on 3 d;SOD levels decreased significantly on 1 d, and then increased gradually , on 14 d, the level of SOD in treatment group recovered to normal , but it was still lower in the control group than normal level (P<0.05);compared with group B, the content of MDA in plasma was lower in group A, and the activity of SOD (P<0.05) was higher than group B.④The levels of serum TNF-αand IL-10 were significantly increased in these two groups , especiallyin group B, and reached the peak on 3 d.Conclusion Edaravone has a good protective effect on the paraquat poisoning by scavenging free radicals and regulation of inflammatory responses , so as to achieve the protective effect of organs , and further reduce the mortality .
