急性有机磷中毒患者血液胆碱酯酶活性值的动态变化及意义

来源 :中国急救医学 | 被引量 : 0次 | 上传用户:xiaocai
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目的 研究急性有机磷中毒 (AOPP)患者全血、血浆及红细胞胆碱脂酶 (ChE)活性值的变化规律。方法 所有49例患者入院后均给予清除毒物、应用 5 %碳酸氢钠、复方解磷注射液、氯磷定和阿托品等治疗。分别于治疗前、治疗后 6~ 12h、2 4、48、72h及出院时抽末梢血测定全血、血浆及ChE活性值 ,并于同期测定当地 32名健康人血液ChE活性值作为正常对照组。结果 全血及红细胞ChE在中毒患者治疗前后均较正常对照组明显降低 (P <0 0 1) ,中、重度存活患者于治疗前已明显降低 ,并分别于治疗后 2 4h时显著降低 ,于 48h后缓慢回升 ,出院时仍未恢复至正常水平 ;2例死亡患者ChE活性持续不回升。血浆ChE活性值波动较大 ,分布较离散 ,恢复相对较快。结论 全血及红细胞ChE抑制后恢复缓慢 ,在临床痊愈后仍未恢复至正常 ,其活性值的变化规律可用以判断病情的发展趋势和预后 ,且在治疗上具有重要的指导意义。 Objective To study the changes of cholinesterase (ChE) activity in whole blood, plasma and erythrocytes in patients with acute organophosphorus poisoning (AOPP). Methods All 49 patients were given detoxification after admission and were treated with 5% sodium bicarbonate, Fufang compound injection, chlorophosphorus and atropine. The blood, plasma and ChE activity were measured before treatment, 6-12h, 24-48h and 72h after treatment, respectively. Blood ChE activity was measured in 32 healthy volunteers at the same period as the normal control group . Results The whole blood and erythrocyte ChE were significantly lower in patients with poisoning than those in normal controls (P <0.01). The patients with moderate and severe survival were significantly reduced before treatment and were significantly decreased at 24 hours after treatment After 48 hours, it recovered slowly and returned to normal level after discharge. The activity of ChE in 2 death patients did not rise continuously. Plasma ChE activity value fluctuations, the distribution is more discrete, the recovery is relatively fast. Conclusion The recovery of ChE in whole blood and erythrocytes is slow, and it has not returned to normal after the clinical cure. The change of its activity value can be used to judge the development trend and prognosis of the disease and has important guiding significance in the treatment.
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