急性对硫磷中毒活性炭血液灌流的疗效研究  

Study on therapeutic effect of hemoperfusion with activated charcoal in treatment of acute parathion poisoning

作　　者：刘鹏[1] 何跃忠[1] 

机构地区：[1]军事医学科学院附属医院急诊科,北京100071

出　　处：《中国工业医学杂志》2008年第5期291-294,共4页Chinese Journal of Industrial Medicine

摘　　要：目的探讨血液灌流(HP)对于急性有机磷农药中毒的治疗效果。方法建立狗急性对硫磷中毒模型:将动物随机分成HP组(进行血液灌流)和对照组(未进行血液灌流)。气相色谱法和速率比色法测定血浆对硫磷浓度、活性炭吸附对硫磷总量和血清丁酰胆碱酯酶活力。结果(1)静脉染毒后,血浆中对硫磷浓度-时间变化曲线符合多室模型,动力学参数如下:t1/2=(15.33±12.95)h,Vd=(13.13±9.99)L/kg,CL=(0.86±0.44)L/(h.kg);(2)HP期间血浆对硫磷浓度下降较快,但此后对硫磷浓度逐渐升高,并于HP后2 h,两组血中对硫磷浓度无统计学差异(P>0.05);(3)活性炭共清除机体毒物负荷总量的(0.25±0.16)%;(4)HP后,丁酰胆碱酯酶活性逐渐升高,36 h达到峰值,此后下降;(5)HP组与对照组比较,昏迷时间[(30.33±6.03)h vs(29.17±5.97)h,P>0.05]差异无统计学意义。结论活性炭血液灌流治疗急性对硫磷中毒作用有限。Objective To assess the therapeutic efficacy of hemoperfusion （HP） in the treatment of acute organophosphorus pesticide poisoning. Methods The parathion injected （ 12 mg/kg） dogs were randomly divided into two groups, HP group （dogs treated with hemoperfusion） and control group （without bemoperfusion treatment）. Then the plasma level of parathion and its content adsorbed by activated charcoal, and the activity of butyrocholinesterase in serum were measured by gas chroma- tography analysis and velocity colorimetry, respectively. Results （ 1 ） The plasma decay curve of parathion was fitted to a multi- compartment model, the kinetic parameters were t1/2 = （ 15.33 ± 12. 95 ） h; Vd = （ 13.13 ± 9. 99 ） L/kg; CL = （0. 86 ± 0. 44） L/ （h · kg）. （2） The parathion levels in plasma were descended rapidly during HP, but it increased again after HP treatment, and the difference between HP group and control group was not significant two hours later after treatment. （3） About （0. 25 ± 0. 16）% of parathion in total body burden were removed by activated charcoal. （4） The activity of pseudocholine-sterase gradually increased, then decreased 36 h later after HP treatment. （5） There was no difference in coma time [ （30. 33 ± 6. 03 ） h vs （29. 17 ± 5.97 ） h, P 〉 0.05 ] between the two groups. Conclusion The results suggested that hemoperfusion only has limited effect in the treatment of acute parathion poisoning.

关 键 词：血液灌流 活性炭 急性中毒 对硫磷 

分 类 号：R139.3[医药卫生—劳动卫生] R459.5[医药卫生—公共卫生与预防医学]