Analysis of Clinical Efficacy and Inflammatory Factor on Hemoperfusion with Plasma Exchange in Patients with Acute Severe Organophosphorus Pesticide Poisoning

LIU Zhuo; WANG Qian-mei; YIN Wen; HUANG Yang

doi:10.3969/j.issn.1002-3429.2015.10.033

Abstract：Objective To explore the clinical efficacy and inflammatory factors on hemoperfusion ( HP) with plasma exchange ( PE) in patients with acute severe organophosphorus pesticide poisoning. Methods A total of 91 patients with acute severe organophosphorus pesticide poisoning ( ASOPP) admitted to our hospital during December 2012 and December 2014 were divided randomly into conventional treatment group (CTG, n=30), hemoperfusion group (HPG, n=30) and he-moperfusion with plasma exchange group (HEG, n=28). In addition to gastric lavage, catharsis and other conventional treat-ment, patients in HPG were given HP and those in HEG were given HP as well as PE. The cure rate, total dosage of atropine and pralidoxime chloride, duration of hospitalization and coma, plasma cholinesterase activity, complications and inflammatory factor including TNF-α, IL-1β, IL-6 and IL-8 before and after treatment of all patients were statistically analyzed. Results In patients of HPG and HEG, the cure rate was significantly improved while total dosage of atropine and pralidoxime chloride, and duration of hospitalization and coma were significantly decreased compared to those in CTG (P<0. 05). Moreover, the above indexes of HEG were decreased as compared with those in the HPG (P<0. 05). HPG and HEG showed a significantly decreased plasma inflammatory factor including TNF-α, IL-1β, IL-6, IL-8 and increased plasma cholinesterase activity at 4 h, 24 h and 72 h after admission compared with CTG and these before treatment in the same group ( P<0. 05 ) . Plasma cholinesterase activity of HEG was higher than that of HPG 24 h after treatment (P<0. 05). HEG showed a significantly de-creased plasma inflammatory factor including TNF-α, IL-1β, and IL-6 compared to HPG after treatment (P<0. 05). Howev-er, there was no difference of IL-8 between HEG and HPG. Conclusion HP with PE is effective in improving the cure rate of ASOPP. Reducing dosage of atropine and pralidoxime chloride, reducing hospitalization time and accelerating CHE activity may be related to eliminating inflammatory factors.