血液灌流对急性重度有机磷中毒患者炎性因子与c反应蛋白的清除作用观察

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1、授予单位代码10089学号或申请号10372HebeiMedicalUniversity硕士学位论文在职科学学位血液灌流对急性重度有机磷中毒患者炎性因子与C反应蛋白的清除作用观察学位申请人：张文忠导师：田英平教授苏建玲副教授专业：急诊医学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组)的指导下，由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文,第一署名为单位河北医科大学，试验材料、原始数据

2、、申报的专利等知识产权均归河北医科大学所有。否则,承担相应法律责任。,;g-研究生签名导师签章:_二级学院领导盖章:产/厂年/月<3日河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果,除了文中特别加以标注和致谢等内容外,文中不包含其他人已经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写,文责自负。研究生签名导师签章：广t年Z月及日目录中文摘要··············································································1英文摘

3、要··············································································4英文缩写··············································································8研究论文血液灌流对急性重度有机磷中毒患者炎性因子与C反应蛋白的清除作用观察前言··············································································9资料

4、与方法····································································10结果·············································································13附图·············································································15附表··············································

5、·······························16讨论·············································································19结论·············································································22参考文献·······································································23综述急性有机磷中毒研究

6、进展···············································26致谢···················································································54个人简历·············································································55中文摘要血液灌流对急性重度有机磷中毒患者炎性因子与C反应蛋白的清除作用观察摘要目的：急性有机磷农药中毒(AOPP)是常见的临

7、床急症，随着早期足量使用复能剂和阿托品的正规应用，抢救重度AOPP的成功率已大幅度增加，但其病死率仍高达26.2％，特别是重度病例病死率仍很高。近年来，有研究者开始关注AOPP与全身炎症反应综合征(SIRS)及多脏器功能障碍综合征(MODS)的关系。有机磷农药进入机体后通过激活免疫活性细胞如中性粒细胞、巨噬细胞等而诱发炎症反应，分泌大量的炎性因子如TNF-α和IL-1等。TNF–α和IL-1是机体重要的促炎细胞因子，并且TNF-α和IL-1等炎性因子含量的增加，也会诱导肝脏合成大量的C反应蛋白（CRP）。CRP在健康人血清中浓度较低，但在炎症、组织损伤后CRP

8、浓度可迅速增加，有机磷进入机体后，造成