The Analysis Of Paraquat Elimination Of Hemoperfusion Combined With Hemodiafiltration Or Continuous Renal Replacement Therapy On Acute Paraquat Poisoning

Objective:To explore the paraquat(PQ)elimination of two combined blood purification methods,HP+HDF and HP+CVVH,on acute PQ poisoning.Methods:16 patients of acute PQ poisoning were enrolled in this project from August2013 to December 2015 in our Hospital.The patients were divided into HP+HDF group(n=7)and HP+CVVH group(n=9).The concentrations of PQ in serum and urine samples were compared between groups.The liver and kidney functions at 3 days,7days were also compared.Results:(1)The serum level of PQ post dialyzer were lower in both groups(P<0.01);(2)The extraction and clearance ratio of PQ in HP+HDF group were higher than that of HP+CVVH group(P<0.05);(3)In the HP+HDF group,the serum concentration of PQ reduced in the first 2 hours,but serum concentration of PQ in 3 patients elevated then.On the contrary,in the HP+CVVH group,the serum concentration of PQ reduced in the first 12 hours,and maintained low level till the end of the blood purification.(4)After the blood purification,the serum concentration of PQ reduced significantly in the HP+CVVH group(P < 0.01),but not in the HP+HDF group(P > 0.05),the PQ concentration of urine reduced significantly in both groups,however,PQ reduction percentage of both serum and urine in HP+CVVH group were higher than that of HP+HDF group.(P < 0.01);(5)The serum level of ALT,AST,SCr and BUN in HP+CVVH group at 7th day were lower than 3rd day(P<0.05).Conclusions:Both blood purification methods can eliminate PQ from blood of patients,and reduce PQ concentration of urine,while the HP+CVVH method can eliminate PQ efficiently and smoothly,avoiding its rebound.The present study provided detail data for the treatment of acute PQ poisoning using HP+HDF and HP+CVVH technologies.