HP联合CRRT治疗阿维菌素中毒的效果观察  

Effects of HP combined with CRRT in treatment of abamectin poisoning

作　　者：黄国亮 范海鹏 闫红 Huang Guoliang;Fan Haipeng;Yan Hong(Department of Emergency,Hospital 180 of PLA,Quanzhou,Fujian,362000,China)

机构地区：[1]解放军180医院急诊科,福建泉州362000

出　　处：《西南国防医药》2018年第12期1198-1201,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的观察血液灌流(HP)联合连续性肾脏替代治疗(CRRT)治疗阿维菌素中毒的效果。方法收治50例阿维菌素中毒患者,随机分为A组(n=25)与B组(n=25),A组采用HP治疗,B组采用HP联合CRRT治疗。比较两组症状改善时间以及治疗前后血清内毒素、芳香氨基酸、血氨、白细胞介素-6(IL-6)、IL-10、肿瘤坏死因子-α(TNF-α)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、尿素氮(BUN)、肌酐(Cr)等指标的变化。结果 B组抽搐停止、烦躁停止、意识清醒、呼吸抑制改善时间均明显短于A组(P <0.05)。治疗后24 h,B组血清内毒素、芳香氨基酸、血氨、IL-6、IL-10、TNF-α、ALT、AST、BUN、Cr水平均较A组明显降低(P <0.05)。结论 HP联合CRRT治疗阿维菌素中毒,能够有效清除患者内毒素及炎性因子,改善肝肾功能,起效更迅速。Objective To observe the effects of hemoperfusion(HP) combined with continuous renal replacement therapy(CRRT) in the treatment of abamectin poisoning. Methods A total of 50 patients with abamectin poisoning were admitted in our hospital and randomly divided into group A and group B(n=25, respectively). Group A was treated with HP and group B with HP combined with CRRT. The symptom improvement time and the changes in the levels of serum endotoxin, aromatic amino acid, blood ammonia, interleukin-6(IL-6), IL-10, tumor necrosis factor-α(TNF-α), alanine aminotransferase(ALT), aspartate aminotransferase(AST), urea nitrogen(BUN), creatinine(Cr) and other indicators before and after the treatment were compared between the two groups.Results The spasm cessation time, restlessness, consciousness and respiratory depression improvement time in group B were significantly shorter than those in group A(P < 0.05). After 24 hours since the treatment, the levels of serum endotoxin, aromatic amino acid, blood ammonia, IL-6, IL-10, TNF-α, ALT, AST, BUN and Cr in group B were significantly lower than those in group A(P < 0.05). Conclusion HP combined with CRRT can effectively remove endotoxin and inflammatory factors in patients, improve liver and kidney functions and take effects more quickly in the treatment of abamectin poisoning.

关 键 词：阿维菌素 中毒 血液灌流 连续性肾脏替代 内环境 内毒素 

分 类 号：R595[医药卫生—内科学]