急性联吡啶类除草剂中毒患者的分馏血浆分离和吸附与连续静脉-静脉血液滤过相结合。

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-07-05 DOI:10.1080/0886022X.2024.2374013
Jian-Hua Dong, Minghong Zhang, Xi Yang, Bian Wu, Li Huang, Chuan Li, Yongchun Ge
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引用次数: 0

摘要

目的评估分馏血浆分离吸附联合持续静脉-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了回顾性分析,其中9例为敌草快中毒,9例为百草枯中毒。所有患者均接受了 FPSA-CVVH 治疗。对农药中毒患者的血清细胞因子水平进行了评估。观察了 FPSA-CVVH 消除细胞因子的疗效、中毒患者的 90 天存活率以及治疗后的不良反应:结果:14 名患者(77.8%)出现急性肾损伤,10 名患者(55.6%)出现急性肝损伤。血清中高迁移率基团蛋白 B-1 (HMGB-1)、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)、巨噬细胞炎症蛋白-1β (MIP-1β)等细胞因子水平明显升高。共进行了 41 次 FPSA-CVVH 治疗。单次 8 小时 FPSA-CVVH 治疗后,HMGB-1、IL-6、IL-8、IP-10、MCP-1 和 MIP-1β 的降幅分别为 66.0%、63.5%、73.3%、63.7%、53.9% 和 54.1%。在FPSA-CVVH治疗期间,一名患者因血浆成分分离器中的凝血而需要更换过滤器,一名患者出现出血不良反应。90天存活率为50%,其中4例为敌草快中毒,5例为百草枯中毒,肝肾功能均恢复正常:结论: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发展过程中起着重要作用。FPSA-CVVH可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存活率,降低不良反应的发生率。
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Fractionated plasma separation and adsorption integrated with continuous veno-venous hemofiltration in patients with acute bipyridine herbicide poisoning.

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
期刊最新文献
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