摘要目的 观察急性有机磷中毒(AOPP)患者血液灌流联合连续性血液净化(CBP)对有机磷的清除及血清抵抗素含量的影响.方法 将120例AOPP患者在常规对症治疗的基础上,分为常规治疗组60例;以及在常规治疗的基础上行活性炭血液灌流(HP)联合连续性静脉-静脉血液滤过治疗组60例(CBP组);各组均在治疗0,12,24,48,72 h时留取血样3 ml.采用ELISA法检测患者循环中抵抗素含量水平.结果 各组AOPP患者治疗前血清抵抗素含量均明显高于正常对照组(P<0.01),且各组治疗前抵抗素含量不存在相关性(P>0.05),经过72 h治疗,各组患者抵抗素水平均明显降低.常规治疗组经过72h治疗,血清抵抗素水平降低缓慢(P<0.05);CBP组治疗后AOPP患者血清抵抗素含量逐渐降低,治疗48h后已显著低于治疗前(P<0.05),治疗72 h后降低更为明显(P<0.01).结论 HP联合CBP治疗可有效清除AOPP患者血液中炎症因子抵抗素,为临床观察CBP的治疗效果提供了新的监测指标.

abstractsObjective To study the effects of hemoperfusion (HP) and continuous blood purification (CBP) treatment treatment on serum resistin in patients with acute orgnaophosphorus pesticides poisoning (AOPP). Methods 120 patients with AOPP were randomly divided into conventional treatment group(60 cases) and sequential HP and continuous venovenous hemofiltration (CBP group, 60 cases). CBP group were treated with continuous blood purification for 72 hours besides conventional treatment. Serum levels of resistin were determined with ELISA dynamically before treatment and 24,48,72and 96 hours after the treatment. Results The level of serum resistin in patients in two AOPP groups was significantly higher than that in control group(P<0.01), there was no correlation between the conventional treatment group and the CBP group (P >0.05), after 72 hours of treatment, serum resistin in each group were significantly lower. To lower serum resistin levels slow in the conventional treatment group(P<0.05), and the gradual lowering of serum resistin levels in the CBP group,48 hours after treatment was significantly lower than before treatment(P<0.05),72 hours after treatment to reduce even more pronounced (P<0.01). Conclusion CBP treatment could reduce the role of resistin which is a inflammatory factor in the blood, and the level of resistin in circulation markedly decreased.Serum resistin testing for the observation of CBP treatment provides a new monitoring indicators.