关键词: 农药中毒, 血液净化, 细胞因子, 临床疗效, 不良反应

Abstract: Ｏｂｊｅｃｔｉｖｅ：To evaluate the clinical efficacy and safety of fractionated plasma separation and adsorption integrated with continuous veno-venous hemofiltration (FPSA-CVVH) treatment in patients with severe pesticide poisoning.
Ｍｅｔｈｏｄｏｌｏｇｙ：In this retrospective study, we enrolled 24 patients with pesticide poisoning (6 patients with organophosphorus pesticide poisoning, 9 patients with pesticide poisoning and paraquat poisoning respectively).The pesticide poisoning dose in all patients had reached or exceeded the poisoning lethal dose, or the poisoning condition grade was moderate to severe or above. The prognosis and adverse effects of FPSA-CVVH treatment in patients, and the effect of FPSA-CVVH on cytokine clearance were observed.
Ｒｅｓｕｌｔｓ：17(70.8％) patients with acute kidney injury and 11(45.8％) with acute liver injury. The serum high mobility group protein B-1(HMGB-1),interleukin-6(IL-6),IL-8,interferon γ-inducible protein-10(IP-10),monocyte chemotactic protein 1(MCP-1) and macrophage inflammatory protein 1β,MIP-1β were significantly increased. All patients underwent 56 sessions of FPSA-CVVH. After 8h of single FPSA-CVVH, HMGB-1, IL-6, IL-8, IP-10, MCP-1 and MIP-1 β decreased by 64.2％, 64.2％, 75.5％, 65.2％, 56.7％ and 56.3％ respectively.One patients had severe coagulation and their filters changed. And other patients exhibited bleeding. The survival rate of 90-day patients was 58.3％(including 5 patients with organophosphorus pesticide poisoning, 4 patients with paraquat poisoning and 5 patients with pesticide poisoning),the liver and kidney functions returned to normal.
Ｃｏｎｃｌｕｓｉｏｎ：FPSA-CVVH can effectively reduce the cytokines level, improve the success rate of patients with severe pesticide poisoning, and low incidence of adverse reactions.

Key words: pesticide poisoning, blood purification, cytokines, clinical efficacy, adverse reactions