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目的 观察库存血保存天数与血浆胆碱酯酶 (CHE)水平变化关系 ,探讨急性重症有机磷农药中毒 (AOPP)抢救中合理选择 ,用于换血疗法或者输血的血源。方法 输血前随机留取保留不同天数的库血测定血浆CHE值 ;血液中心采血当日留取正常人血浆、即日测定CHE值作对照组。CHE测定用BM公司的胆碱酯酶试剂盒 ,Roch公司的Cobas FaraⅡ自动分析仪测定。结果 库存血保存天数为第一天的血浆CHE值与正常对照组比较差异无显著性 (P >0 0 5 ) ,第二天以后的各组均显著低于对照组 (P <0 0 5 )。各组与正常对照组相比较 ,其定基比约为 80 %~ 16 %。保存天数与CHE值呈负相关 (r=- 0 792 9,P <0 0 1)。曲线回归Y =- 182 3 3Ln(X) +6 2 2 9 4。结论 随采血后库存血保存天数的增加 ,血浆CHE值逐渐下降。在重度AOPP抢救中 ,以使用保留天数为 1d以内新鲜血最为适宜 ,以免贻误抢救时机。本报告为强调输入新鲜血液 ,保证高活性CHE输入提供实验依据。
Objective To observe the relationship between the number of days of blood storage and the change of plasma cholinesterase (CHE) level, and to explore the rational selection of acute severe organophosphorus pesticide poisoning (AOPP) for blood transfusion therapy or blood transfusion. Methods Blood samples were collected randomly before blood transfusion to determine the plasma CHE value. Blood samples were taken from normal blood plasma on the day of blood collection. The daily CHE value was measured as the control group. The CHE assay was performed using a cholinesterase kit from BM Company and a Cobas Fara II automated analyzer from Roch. Results There was no significant difference in plasma CHE between the first day and the first day (P> 0.05). The levels of plasma CHE in the first day were lower than those in the control group (P <0.05) . Each group compared with the normal control group, its fixation ratio is about 80% ~ 16%. The number of days saved was negatively correlated with CHE (r = - 0 792 9, P <0 0 1). Curve regression Y = - 182 3 3Ln (X) +6 2 2 9 4. Conclusions With the increase of blood storage days after blood collection, the plasma CHE value decreased gradually. Severe AOPP rescue, to use the retention of fresh blood within 1d the most appropriate, so as not to delay the rescue opportunity. This report provides an experimental basis for emphasizing the input of fresh blood and ensuring high activity of CHE input.