Influence of sequential blood purification therapy on myocardial injury and serum inflammatory cytokine levels in patients with organophosphate poisoning.

Abstract

Objective: To evaluate the impact of sequential blood purification therapy on myocardial injury and serum inflammatory cytokine levels in patients with organophosphorus poisoning.

Methods: The clinical data of 67 patients hospitalized for organophosphorus poisoning from January 2020 to January 2021 in Anxi County Hospital were retrospectively analyzed. The patients were divided into a control group (n = 30, received conventional treatment plus hemoperfusion) and a research group (n = 37, received conventional treatment plus sequential blood purification therapy [hemoperfusion plus continuous veno-venous hemofiltration (CVVH)]). The clinical efficacy, myocardial injury indicators, inflammatory cytokine levels, liver and kidney function, incidence of complications, and mortality rate were compared between the two groups.

Results: The research group showed a significantly higher total effective rate of 94.59% compared to 73.33% in the control group (P < 0.05). Fewer doses of penehyclidine were administered in the research group, compared to the control group (P < 0.05). In addition, the duration of penehyclidinezation, wakefulness, recovery of CHE activity, mechanical ventilation and hospitalization in the research group was significantly shorter than those in the control group (all P < 0.05). After treatment, both groups exhibited decreased levels of serum NSE, cTnI, CK-MB, LDH, Myo, WBC, CRP, PCT and IL-6, with lower levels in the research group (P < 0.05). Conversely, both groups showed elevated levels of serum CHE, BUN, Scr, urine protein, AST, TBIL and ALT, with higher levels in the control group (P < 0.05). On the 1st and 2nd days after treatment, the serum NSE levels in the observation group were lower than those in the control group, while the serum CHE levels were higher than those in the control group (all P < 0.05). On the 3rd day after treatment, serum NSE and CHE levels were not significantly different between the two groups. The incidence of rebound in the research group was significantly lower (8.11% vs. 30.00%, P < 0.05) than that in the control group. The mortality rates did not show statistically significant differences between the two groups (10.00% vs. 2.70%, P > 0.05).

Conclusion: Sequential blood purification therapy can effectively mitigate myocardial injury, reduce the expressions of inflammatory cytokines, and protect liver and kidney function in patients with organophosphorus poisoning, with a favorable safety profile.