■评估分级血浆分离和吸附联合连续静脉-静脉血液滤过(FPSA-CVVH)治疗急性联吡啶类除草剂中毒患者的临床疗效和安全性。
■对18例急性联吡啶类除草剂中毒患者进行回顾性分析,其中9例患者被敌草中毒,9例患者被百草枯中毒。所有患者均接受FPSA-CVVH治疗。评估了农药中毒患者的血清细胞因子水平。FPSA-CVVH在消除细胞因子,中毒患者的90d生存率,并观察治疗后的不良反应。
■14例(77.8%)有急性肾损伤,10例(55.6%)有急性肝损伤。高迁移率族蛋白B-1(HMGB-1)的血清细胞因子水平,白细胞介素-6(IL-6),IL-8,干扰素诱导蛋白-10(IP-10),单核细胞趋化蛋白-1(MCP-1),巨噬细胞炎性蛋白-1β(MIP-1β)明显升高。总共进行了41次FPSA-CVVH治疗。在单次8小时FPSA-CVVH治疗后,HMGB-1、IL-6、IL-8、IP-10、MCP-1和MIP-1β下降66.0%,63.5%,73.3%,63.7%,53.9%,和54.1%,分别。在FPSA-CVVH治疗期间,一名患者由于血浆成分分离器凝结而需要更换过滤器,其中一人出现出血不良反应.90d患者生存率为50%,有4例敌快中毒患者和5例百草枯中毒患者,肝肾功能均恢复正常.
■细胞因子风暴可能在急性联吡啶类除草剂中毒患者多器官功能障碍的进展中起重要作用。FPSA-CVVH能有效降低细胞因子水平,提高急性联吡啶类除草剂中毒患者的生存率,并降低不良事件的发生率。
UNASSIGNED: To evaluate the clinical efficacy and safety of fractionated plasma separation and adsorption combined with continuous veno-venous hemofiltration (FPSA-CVVH) treatment in patients with acute bipyridine herbicide poisoning.
UNASSIGNED: A retrospective analysis of 18 patients with acute bipyridine herbicide poisoning was conducted, of which 9 patients were poisoned by diquat and 9 patients by paraquat. All patients underwent FPSA-CVVH treatment. The serum cytokine levels in pesticide-poisoned patients were assessed. The efficacy of FPSA-CVVH in eliminating cytokines, the 90-d survival rate of poisoned patients, and adverse reactions to the treatment were observed.
UNASSIGNED: Fourteen patients (77.8%) had acute kidney injuries and 10 (55.6%) had acute liver injuries. The serum cytokine levels of high mobility group protein B-1 (HMGB-1), interleukin-6 (IL-6), IL-8, interferon-inducible protein-10 (IP-10), monocyte chemotactic protein-1 (MCP-1), and macrophage inflammatory protein-1β (MIP-1β) were significantly elevated. A total of 41 FPSA-CVVH treatment sessions were administered. After a single 8-h FPSA-CVVH treatment, the decreases in HMGB-1, IL-6, IL-8, IP-10, MCP-1, and MIP-1β were 66.0%, 63.5%, 73.3%, 63.7%, 53.9%, and 54.1%, respectively. During FPSA-CVVH treatment, one patient required a filter change due to coagulation in the plasma component separator, and one experienced a bleeding adverse reaction. The 90-d patient survival rate was 50%, with 4 patients with diquat poisoning and 5 patients with paraquat poisoning, and both liver and kidney functions were restored to normal.
UNASSIGNED: Cytokine storms may play a significant role in the progression of multiorgan dysfunction in patients with acute bipyridine herbicide poisoning. FPSA-CVVH can effectively reduce cytokine levels, increase the survival rate of patients with acute bipyridine herbicide poisoning, and decrease the incidence of adverse events.