目的探讨氯磷定冲击治疗对重度有机磷农药中毒患者氧化应激损伤及血管内皮功能的影响.方法选择2016年7月—2017年6月江苏省南通市第一人民医院收治的重度有机磷农药中毒患者112例为研究对象,采用前瞻性研究的方法随机分为观察组和对照组各56例.对照组给予氯解磷定常规剂量治疗,观察组给予氯解磷定冲击治疗.比较两组患者相关治疗指标、氧化应激、血管内皮功能、预后等.结果观察组患者阿托品用量明显少于对照组,氯解磷定用量明显高于对照组,血清胆碱酶活性恢复＞50%时间、住院时间明显短于对照组(t=63.435, 14.898, 20.681, 8.324, P<0.05, P<0.01);血清黄嘌呤氧化酶(XO)、丙二醛(MDA)含量明显低于对照组,超氧化物歧化酶(SOD)含量明显高于对照组(t=6.095, 8.002, 7.079, P<0.05);血清一氧化氮(NO)、P选择素含量明显低于对照组(t=8.787, 10.094, P<0.05, P<0.01);中间综合征、死亡率明显低于对照组(8.93% vs 28.57%, 5.36% vs 19.64%)(x2=7.092, 5.224, P<0.05).结论氯磷定冲击治疗有助于迅速恢复重度有机磷中毒患者血清胆碱酯酶活性,缩短住院时间,改善患者预后,可能与抑制氧化应激损伤、调节血管内皮功能等因素有关.“,”Objective To investigate the effects of chlorhexidine shock therapy in treatment of severe organophosphorus pesticide poisoning. Methods 112 patients with severe organophosphorus pesticide poisoning were randomly divided into 2 equal groups:Observation group Under going chlorhexidine shock therapy in addition to conventional treatment and maintenance dose of atropine, and control group undergoing conventional treatment with maintenance dose of atro?pine. The dosages of atropine and chlorhexidine and hospitalization time were calculated.Peripheral venous blood sam?ples were collected 24h, 72 h, and 96 h after the treatment to test the whole blood cholinesterase activity, serum cholines?terase activity, time for recovery of Cholinnest erase activiry more than 50%. Before treatment and 1 week after treatment peripheral blood samples were collected to test the levels of xnthine Oxidase(XO), superoxide d ismutase, (SOD), and malondialdehyde (MDA)., nitric oxide (N)), and P-selectin. Results The dosage of atropine of the observation group tro?pine in the observation group was significantly lower than that of the control group, and the dosage of chlorhexidine of the observation group was significantly higher than that of the control group. The time of recovery of serum cholinease ac?tivity to＞50%, and the hospital stay time of the observation group was significantly shorter than the control group (t=63.435, 14.888, 20.681, 8.324, P<0.05, P<0.01); the serum levels of XO and MDA of the observation group were both significantly lower than those of the control group, and the SOD level of the observation group was significantly higher than that of the control group (t=6.095, 8.002, 7.079, P<0.05); The serum levels of NO and P-selectin were significantly lower than those of the control group (t=8.787, 10.094, P<0.05, P<0.01); The incidence rate of intermediate syndrome, mortality of the observation group were both significantly lower than those of the control group (8.93% vs 28.57%, 5.36% vs 19.64%) (x2=7.092, 5.224, P<0.05). Conclusion Chlorpheniramine shock treatment quickly restores the serum cho?linesterase activity in patients with severe organophosphorus poisoning, shortens the hospital stay and improvesthe prog?nosis, which may be related to inhibition of oxidative stress injury and regulation of vascular endothelial function.