Objective To investigate the effect of hemoperfusion on the changes of myocardial enzymes and inflammatory indexes in patients with severe organophosphorus pesticide poisoning and myocardial injury.Methods We retrospectively analyzed 80 patients with severe organophosphorus pesticides with myocardial injury seen in our hospital from January 2018 to December 2022, and divided into a control group (30 patients) and an observation group (50 patients) according to whether blood perfusion treatment was performed during the actual treatment period, with the control group treated with conventional salvage treatment and the observation group treated with blood perfusion on the basis of the control group. The Glasgow Coma Index (GCS) score, serum cholinesterase (ChE), lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), actin (cTnI.), procalcitonin (PCT) and C-reactive protein (CRP) levels and clinical efficacy were compared between the two groups before and after treatment. According to the clinical efficacy, the observation group was divided into three subgroups: cured group, effective group and ineffective group, and the serum levels of ChE, LDH, CK, CK-MB, cTnI., PCT and CRP of patients with different efficacy were compared. Results After treatment, the serum levels of LDH, CK, CK-MB, cTnI., PCT and CRP in both groups were significantly lower than those before treatment, ChE level and GCS score were significantly higher than before treatment (P<0.05). The serum LDH, CK, CK-MB, PCT, CRP levels in the observation group were significantly lower than those in the control group, and ChE levels were significantly higher than those in the control group (P<0.05). With the increase of clinical efficacy, serum LDH, CK, CK-MB, cTnI., PCT, The CRP level decreased gradually and the ChE level gradually increased, and the difference between the two comparisons was statistically significant(P<0.05).Conclusion Hemoperfusion has a significant effect on the treatment of patients with severe organophosphorus pesticide poisoning and cardiac injury, which can significantly reduce the level of myocardial enzyme spectrum (LDH, CK, CK-MB, cTnI.) and inflammatory indexes (PCT, CRP), which has a positive effect on myocardial injury and inflammatory response, and the more significant the curative effect, the faster the serum level decreases