目的 探讨血液灌流联合血液透析(HP+HD)对百草枯中毒患者生存率的影响,并分析其预后因素。方法 对2010 年6月~2013 年5月因口服百草枯就诊于我院的67例患者进行回顾性分析,按照治疗方法的不同分为对照组、HP+HD组、强化HP+HD组,对三组患者进行生存状况分析。生存率的估计采用Kaplan-Meier法;生存率的比较采用log-rank检验;多因素分析采用Cox回归分析。结果 三组患者30天的生存率分别为20.8%、30.2%、37.0%,三组生存率曲线的差别有统计学意义(χ2=6.22,P=0.04);HP+HD强度、服毒量、治疗前血中百草枯浓度的RR值分别为0.81、1.04、1.19,P值分别为0.00、0.01、0.00。结论 强化HP+HD组患者的生存率明显高于另外两组。HP+HD强度、服毒量、治疗前血中百草枯浓度是影响百草枯中毒患者预后的独立因素。HP+HD可提高患者的生存率。
Objective To analyze the survival rate and prognostic factors in paraquat intoxication patients treated with hemoperfusion combined with hemodialysis (HP+HD). Methods A total of 67 paraquat intoxication patients treated in this hospital in the period from June 2010 to May 2013 were retrospectively analyzed. They were divided into control group, HP+HD group and enhanced HP+HD group base on the treatment method. Kaplan-Meier analysis was performed for the estimation of survival rate, which was then compared among the three groups by using the log-rank test. Cox regression was used for multivariate analysis. Results The survival rate after the treatment for 30 days was 20.8%, 30.2%, and 37.0% in control group, HP+ HD group and enhanced HP+HD group, respectively. The survival curve was statistically different among the three groups (χ2=6.22, P = 0.04). The RR value was 0.81 (P=0.00) for HP+HD frequency, 1.04 (P=0.01) for paraquat intoxication amount, and 1.19 (P=0.00) for plasma paraquat concentration before treatment. Conclusions The enhanced HP+HD group had the highest survival rate among the three groups. HP+HD frequency, paraquat intoxication amount, and plasma paraquat concentration before treatment were the independent factors affecting prognosis. HP+HD can improve the survival rate in patients with paraquat intoxication.