Continuous hemoperfusion relieves pulmonary fibrosis in patients with acute mild and moderate paraquat poisoning

• Published in: Journal of toxicological sciences Vol. 45; no. 10; pp. 611 - 617
• Main Authors: Xiao, Qingmian, Wang, Weizhan, Qi, Hongna, Gao, Xun, Zhu, Baoyue, Li, Jing, Wang, Pu
• Format: Journal Article
• Language: English
• Published: Suita The Japanese Society of Toxicology 2020; Japan Science and Technology Agency
• Subjects: Acute paraquat poisoning; Antidotes; Fibrosis; Growth factors; Haemoperfusion; Hemoperfusion; Lung diseases; Malondialdehyde; N-terminal procollagen Ш propeptide; Oxidative stress; Paraquat; Patients; Poisoning; Procollagen; Public health; Pulmonary fibrosis; Statistical analysis; Superoxide dismutase; Survival; Transforming growth factor-b1
• ISSN: 0388-1350; 1880-3989
• DOI: 10.2131/jts.45.611

Acute paraquat poisoning (APP) is a serious public health problem with a high mortality rate and there is no specific antidote for APP in clinical. Early haemoperfusion (HP) treatment is effective in APP rescue. In this study, we compared the influence of routine HP and continuous HP on the survival rate and the treatment of pulmonary fibrosis in mild and moderate APP patients. Eighty-two cases of mild and moderate APP patients who were admitted to our hospital from January of 2017 to December of 2018 were selected. All patients were randomly divided into a routine haemoperfusion (HP) group (n = 40) and a continuous haemoperfusion (CHP) group (n = 42). Compared with the HP group, the 28-day survival rate of mild and moderate APP patients was elevated in the CHP group. Blood N-terminal procollagen Ш propeptide (PIIINP) levels in APP patients were positively related with paraquat (PQ) concentration (r = 0.309, P = 0.000). There were statistically significant differences in the levels of PIIINP, Collage TypeIV (CIV), transforming growth factor-beta 1 (TGF-β1), malondialdehyde (MDA), superoxide dismutase (SOD) activity and sequential organ failure assessment (SOFA) score between the two groups both on the third and seventh days after treatment, and the treatment effect of the CHP group on pulmonary fibrosis in APP patients was better than that of the HP group. In conclusion, CHP treatment had a significant therapeutic effect on mild and moderate APP patients, which could effectively improve the survival rate and relieve pulmonary fibrosis.