血液灌流联合血液透析治疗百草枯中毒的疗效分析  

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

作　　者：薛兰芬[1] 陈敏[1] 刘娜[1] 许静[1] 杨国卿[1] 崔岭[1] 

机构地区：[1]石家庄市第一医院,石家庄050011

出　　处：《中国血液净化》2014年第2期82-84,共3页Chinese Journal of Blood Purification

摘　　要：目的 探讨血液灌流联合血液透析（hemoperfusion,HP＋ hemodiMysis,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石家庄市第一医院的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3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 3组患者30天的生存率分别为20.8％、30.2％、37.0％,3组生存率曲线的差别有统计学意义（x26.22,P=0.04）;HP＋HD强度、服毒量、治疗前血中百草枯浓度的册值分别为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2组.HP＋HD强度、服毒量、治疗前血中百草枯浓度是影响患者预后的独立因素.HP＋HD可提高患者的生存率.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 （x2=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.

关 键 词：百草枯 生存率 血液灌流 血液透析 COX回归分析 

分 类 号：R459.5[医药卫生—治疗学]