持续血液灌流对急性百草枯中毒患者血浆 炎症及氧化应激损伤指标的影响

Effect of continuous hemoperfusion on plasma levels of presepsin, inflammatory factors and oxidation indexes in patients with acute paraquat poisoning

摘要:

目的 研究持续血液灌流（HP）对急性百草枯中毒（APP）患者血浆Presepsin 及其他炎症因子水平、 氧化应激损伤指标的影响。方法 选取该院收治的APP 患者92 例，分成对照组和治疗组，分别于治疗前及治 疗后3 d 检测MDA、SOD、TNF-α 及IL-6 水平；治疗前及治疗后6、12 和24 h 检测血Presepsin 及百草枯 （PQ）浓度，并进行分析。结果 两组患者治疗前MDA、SOD、TNF-α 及IL-6 水平比较无差异（P >0.05）； 两组患者治疗后MDA、SOD、TNF-α 及IL-6 水平比较有差异（P <0.05）。两组患者血浆Presepsin、PQ 水 平比较有差异（P <0.05）。APP 患者治疗前血浆Presepsin 水平与PQ 浓度呈正相关（P <0.05）。治疗后24 h， 血浆Presepsin 水平与PQ 浓度无相关性（P >0.05）。结论 持续HP 可减低APP 患者血浆Presepsin 及其他炎 症因子水平，减轻氧化应激损伤，改善预后。

Abstract:

Objective To study the effect of continuous hemoperfusion on plasma presepsin, inflammatory factor levels and oxidative indexes in the patients with acute paraquat poisoning (APP). Methods Ninety-two cases of APP were randomly divided into a control group and a treatment group. Before treatment and 3 d after treatment, the levels of malondialdehyde (MDA), serum superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α), and interleukin 6 (IL-6) were detected. Before treatment and 6, 12 and 24 h after treatment, presepsin and blood plasma paraquat concentration were detected. The results were compared between the two groups. Results There was no difference in the level of SOD, MDA, TNF-α or IL-6 between the two groups before treatment (P > 0.05), but there were significant differences in the levels of SOD, MDA, TNF-α and IL-6 between the two groups after treatment (P < 0.05). There was no difference in plasma presepsin or paraquat concentration between the two groups before treatment (P > 0.05). The plasma paraquat concentration decreased gradually at 12 and 24 h after treatment, and the difference between the two groups was statistically significant (P < 0.05). The plasma presepsin level increased at 12 and 24 h after treatment, the difference was statistically significant between the two groups (P < 0.05). There was a positive correlation between plasma presepsin level and paraquat concentration in the patients with APP before treatment (P < 0.05). There was no correlation between plasma presepsin level and paraquat concentration 24 h after treatment (P > 0.05). Conclusions Continuous hemoperfusion therapy can decrease the levels of plasma presepsin and inflammatory factors, reduce oxidative stress injury and improve the prognosis of the patients with APP. The level of presepsin in plasma can be used to evaluate the condition of the patients and guide the clinical treatment.