The Investigation Of The Curative Effect Of Benazepril And Valsartan Combined With Hemoperfusion In The Treatment Of Acute Paraquat Poisoning

ObjectiveTo investigate benazepril and valsartan combined with hemoperfusion in the treatment of acute paraquat poisoning curative effect and possible mechanism. Methods :The data of acute paraquat poisoning cases from July 2002 to August 2014 in our Emergency Department were retrospectively reviewed.All the patients were divided into three groups.Patients in A group were treated with routine therapy.Group B treatment was based on conventional treatment with benazepril plus valsartan anti pulmonary fibrosis treatment. Patients in group C were treated with hemoperfusion on the basis of B group.All three groups of continuous measurement data was in accordance with normal distribution data using analysis of variance, skewness data using non-parametric analysis of Kruskal-Wallis test, chi-square test was used to compare from multiple rates. The survival curves were compared with the Kaplan-Meier inspection analysis.ResultsA total of 70 patients were chosen for the study.There were 18 cases in group A,21 cases in group B and 31 cases in group C. Among the three groups,there was notstatistically significant differences in age, sex, poisonous, dose and treatment time(P>0.05). Paraquat poisoning can occur in patients with acute liver and kidney dysfunctionin a short time, the biochemistry suggested creatinine(CREA), urea nitrogen(BUN),alanine aminotransferase(ALT), aspertate aminotransferase(AST), total bilirubin(TBIL),et al improved significantly. After active treatment, the biochemical indicatorsof survivors back to normal in 14 days. There were no obvious changes between GroupB and group A about CREA, BUN, ALT, AST, TBIL. But the survival rate of group Bwas significantly higher than group A,The CREA, ALT, AST, TBIL of Group Ccomparing with group B and group A was decreased obviously, presenting statisticallydifference, but there was no statistical difference of the BUN between the three groups.Kaplan Meier survival curve analysis suggested that the survival rate between the theregroups is C > B > A. The median survival time for three groups is group A 5 d, groupB 6 d, group C 60 d.ConclusionLarge doses of benazepril, valsartan combined with hemoperfusion will reduce paraquat poisoning liver, renal dysfunction, and significantly improve the survival rate and survival time of patients with acute paraquat poisoning. This study shows that large doses of angiotensin-converting enzyme inhibitor agents, angiotensin Ⅱ receptor antagonist did not aggravate liver and kidney damage. The three groups had no significant BUN considering the differences in patients with acute paraquat poisoning in stress. Negative nitrogen balance of many factors shows no significantly difference ofthe 3 groups in the index. It is proved that there is no effective antidote to paraquat, therefore, we still advocate hemoperfusion combined therapy.