Analysis of the influencing factor of prognosis in acute paraquat poisoning patients

Objective: To investigate the influencing factor of prognosis,and effects of hemoperfusion removing the inflammatory mediators and paraquat in paraquat poisoning patients.Methods: The clinical data of 35 patients with acute paraquat poisoning were investigated.All cases were treated with conventional method combined with HA230 resin hemoperfusion.The patients were divided into the survival group and death group according to the prognosis.The paraquat concentration,levels of IL-6 and GSH-PX,and activities of MDA and SOD in two groups between before and after the first hemoperfusion were compared.The correlations of the paraquat concentration,sex,age,time of the poisoning to first time blood perfusion,time of the liver,kidney and cardiac injury and blood routine indicators with prognosis were analyzed.Results: Among 35 cases,20 cases survived,15 cases died,and the death rate was 42.9%.The differences of the time of the poisoning to first time blood perfusion,time of the liver,kidney and cardiac injury,white blood cell count and neutrophil count between two groups were statistically significant(P<0.05 to P<0.01).Compared with before hemoperfusion,the paraquat concentration in two groups after perfusion decreased significantly(P<0.01),the SOD activity increased significantly(P<0.01).The paraquat concentration in survival group before and after the first perfusion was significantly lower than that in death group,and the differences of the levels of SOD,GSH-PX,IL-6 and MDA in two groups between before and after perfusion were not statistically significant(P>0.05).Conclusions: HA230 resin hemoperfusion can effectively remove paraquat,and improve the activity of SOD.The plasma concentration of paraquat,time of the poisoning to the first perfusion,time of liver,kidney and cardiac injury,white blood cell count,neutrophil count are the prognosis influencing factors of acute paraquat poisoning.