Studying The Therapic Effects Of Hemoperfusion With Continuous Venovenous Hemofiltration On The Patients With Acute Paraquat Poisoning And The Correlaion To The Disease Prognosis

ObjectiveTo explore the therapic effects of hemoperfusion (hemoperfusion HP) with continuous venovenous hemofiltration (continuous venovenous hemofiltration, CVVH) and the prognosis of the paraquat concentration in plasma, interleukin-1 (interleukin-1, IL-1), tumor necrosis factor-a( tumor necrosis factor-a, TNF-a) , transforming growth factor-? (transforming growth factor-P,TGF-?)on the patients with acute paraquat poisoning (acute paraquat poisoning, APP).Methods70 cases of APP were treated in emergency department of Affiliated Hospital of Binzhou Medical College from October 2013 to February 2015 , randomly divided into conventional treatment group (32 cases), HP with CVVH treatment group (HP-CVVH group, 38 cases), and collect the clinical data of the patients and blood samples of just by admission,before hemoperfusion and after hemoperfusion(before hemofiltration) , and after hemofiltrationto,by using high performance liquid chromatography (HPLC) to detect the the paraquat concentration in plasma when ust by admission,before hemoperfusion and after hemoperfusion (before hemofiltration),and after hemofiltrationto. by using ELISA technology to detect levels of interleukin-1 (interleukin-1, IL-1),tumor necrosis factor-a (tumor necrosis factor-a , TNF-a ) ,transforming growth factor-?(transforming growth factor-? , TGF-? ) when by admission,, after hemoperfusion (before hemofiltration),and after hemofiltration.Comparison of HP-CVVH group with white blood cells before and after induced flow of blood before and after paraquat concentration changes,,, blood filtration -1 (IL-1),, tumor necrosis factor alpha (TNF- alpha),,transforming growth factor beta(TGF- beta) level change,Compare the change of the paraquat concentration in plasma before HP-CVVH with after HP-CVVH , and the change of interleukin-1 (interleukin-1, IL-1) , tumor necrosis factor-a (tumor necrosis factor-a, TNF-a),transforming growth factor-? (transforming growth factor-?, TGF-?) before hemofiltration through after hemofiltration. The plasma paraquat concentration,interleukin-1 (interleukin-1, IL-1),tumor necrosis factor-a (tumor necrosis factor-?,TNF-?),transforming growth factor-?(transforming growth factor-?, TGF-?) and the 2 months died rate were compared between the two groups.ResultsAfter hemoperfusion , the plasma paraquat concentration decreased significantly (from 13.86±2.25mg/L to3.76±0.74mg/L , P < 0.01) ; after hemofiltration,the level of interleukin-1(interleukin-1,IL-1) decreased significantly (from 328.75±214.32ng/L to276.81±189.38ng/L,P<0.01 ), after hemofiltration, the level of tumor necrosis factor-a (tumor necrosis factor-?, TNF-?)decreased significantly (from 356.54±112.79ng/L to312.86±98.17ng/L , P<0.01 ),after hemofiltration , the level of transforming growth factor-? (transforming growth factor-?, TGF-?)decreased significantly (from 1719.05±498.13ng/Lto1550.26±574,73ng/L, P<0.01 ). Compared the HP-CVVH group with the control group , after HP-CVVH treatment the levels of the paraquat concentration in plasma, interleukin-1 (interleukin-1, IL-1), tumor necrosis factor-?( tumor necrosis factor-?,TNF-?) ,transforming growth factor-? (transforming growth factor-?,TGF-?) were significantly decreased, and can significantly prolong the survival time (P <0.01), but not reduce overall mortality.ConclusionFor APP patients,HP-CVVH treatment can effectively remove the paraquat of blood, and can effectively remove a variety of inflammatory cytokines,prolong the survival time of the patients,play a certain therapeutic effect, but failed to reduce overall mortality.