中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (02): 82-84.doi: 10.3969/j.issn.1671-4091.2014.02.005

• 临床研究 • 上一篇    下一篇

血液灌流联合血液透析治疗百草枯中毒的疗效分析

薛兰芬,陈敏,刘娜,许静,杨国卿,崔岭   

  1. 石家庄市第一医院
  • 收稿日期:2013-09-27 修回日期:2013-11-21 出版日期:2014-02-12 发布日期:2014-02-12
  • 通讯作者: 薛兰芬 xlf123007@sina.com E-mail:xlf123007@sina.com

Therapeutic effect of hemoperfusion combined with hemodialysis on patients with paraquat intoxication

  • Received:2013-09-27 Revised:2013-11-21 Online:2014-02-12 Published:2014-02-12

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摘要： 目的　探讨血液灌流联合血液透析（HP+HD）对百草枯中毒患者生存率的影响，并分析其预后因素。方法　对2010 年6月~2013 年5月因口服百草枯就诊于我院的67例患者进行回顾性分析，按照治疗方法的不同分为对照组、HP+HD组、强化HP+HD组，对三组患者进行生存状况分析。生存率的估计采用Kaplan-Meier法；生存率的比较采用log-rank检验；多因素分析采用Cox回归分析。结果 三组患者30天的生存率分别为20.8%、30.2%、37.0%，三组生存率曲线的差别有统计学意义（χ2=6.22，P=0.04）；HP+HD强度、服毒量、治疗前血中百草枯浓度的RR值分别为0.81、1.04、1.19，P值分别为0.00、0.01、0.00。结论　强化HP+HD组患者的生存率明显高于另外两组。HP+HD强度、服毒量、治疗前血中百草枯浓度是影响百草枯中毒患者预后的独立因素。HP+HD可提高患者的生存率。

关键词: 百草枯, 生存率, 血液灌流, 血液透析, Cox回归分析

Abstract: Objective To analyze the survival rate and prognostic factors in paraquat intoxication patients treated with hemoperfusion combined with hemodialysis (HP+HD). Methods A total of 67 paraquat intoxication patients treated in this hospital in the period from June 2010 to May 2013 were retrospectively analyzed. They were divided into control group, HP+HD group and enhanced HP+HD group base on the treatment method. Kaplan-Meier analysis was performed for the estimation of survival rate, which was then compared among the three groups by using the log-rank test. Cox regression was used for multivariate analysis. Results The survival rate after the treatment for 30 days was 20.8%, 30.2%, and 37.0% in control group, HP+ HD group and enhanced HP+HD group, respectively. The survival curve was statistically different among the three groups (χ2=6.22, P = 0.04). The RR value was 0.81 (P=0.00) for HP+HD frequency, 1.04 (P=0.01) for paraquat intoxication amount, and 1.19 (P=0.00) for plasma paraquat concentration before treatment. Conclusions The enhanced HP+HD group had the highest survival rate among the three groups. HP+HD frequency, paraquat intoxication amount, and plasma paraquat concentration before treatment were the independent factors affecting prognosis. HP+HD can improve the survival rate in patients with paraquat intoxication.

Key words: Paraquat, Survival rate, Hemoperfusion, Hemodialysis, Cox regression analysis