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Effect of Continuous bedside Hemofiltration on Serum AST cTnI AMS and Serum Inflammatory Factors in Patients with Acute Organophosphorus Pesticide Poisoning |
DOU Yue, ZHU Guolian, SUN Xiaoxu |
The Fifth People's Hospital of Shenyang,Liaoning Shenyang 110023,China |
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Abstract Objective: To explore the continuous bedside hemofiltration (continuous renal replacement therapy,CRRT) on levels of serum aspartate aminotransferase (AST),troponin I (cTnI),serum amylase (AMS) and serum inflammatory factors in patients with acute organophosphorus pesticide poisoning (AOPP).Methods: The clinical data of 132 AOPP patients admitted between January 2009 and December 2019 were retrospectively analyzed.The patients were divided into observation group (n=64) and control group (n=68) according to blood purification methods.Control group was treated with hemoperfusion (HP),and observation group was combined with CRRT on this basis.The treatment effects (case fatality rate) and recovery process (atropine dosage,atropinizationtime,awake time,cholinesterase recovery time,mechanical ventilation time,length of hospital stay) were compared between the two groups.The organ damage (AST,cTnI,AMS) and serum inflammatory factors [interleukin 6 (IL-6),tumor necrosis factor-α (TNF-α),hypersensitive C-reactive protein (hs-CRP)] were compared between the two groups before treatment and at 12h and 24h of treatment.The incidence rates of complications were recorded in the two groups.Results: ①There was no statistically significant difference in case fatality rate between the two groups (P>0.05).The atropine dosage,atropinization time,awake time,cholinesterase recovery time,mechanical ventilation time and hospital stay in observation group were all less than those in control group (P<0.05).②Before treatment,at 12h of treatment and at 24h of treatment,the levels of AST,cTnI,AMS,IL-6,TNF-α and hs-CRP in the two groups showed a downward trend (P<0.05),and the AST,cTnI and AMS in observation group at each time point were lower than those in control group (P<0.05),and there were interaction effects between AST,cTnI and AMS and time among different treatment methods (P<0.05).③The incidence rate of rebound phenomenon in observation group was lower than that in control group (P<0.05),and there were no significant differences in the incidence rates of intermediate syndrome,lung infection,multiple organ dysfunction and gastrointestinal bleeding between the two groups (P>0.05).Conclusion: CRRT can improve the levels of AST,cTnI and AMS in AOPP patients,and it is beneficial to improving the efficacy of AOPP patients to a certain extent.
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