急性乐果中毒大鼠肝脏损害及不同剂量氯磷定的治疗影响  

Effects of Acute Rogor Poisoning on Hepatic Injury in Rats and Treatment Efficacy of Various Doses of PAM-CL

作　　者：高恒波[1] 田英平[1] 姚冬奇[1] 苏建玲[1] 佟飞[1] 马玉腾[1] 霍书花[1] 陈慧[1] 王英辉 

机构地区：[1]河北医科大学第二医院急诊科,石家庄050000 [2]正定县医院肛肠科,河北正定050800

出　　处：《临床误诊误治》2010年第7期601-603,F0002,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生厅医学重点指令课题(08116)

摘　　要：目的观察急性乐果中毒大鼠肝脏损害病理改变,以及不同剂量氯磷定的治疗效果。方法将180只染毒大鼠分为对照组、未治疗组、阿托品组及大、中、小剂量氯磷定组和单用阿托品组。观察不同治疗组染毒大鼠疗效,并通过光镜及透射电镜观察肝脏组织病理学及超微结构的改变,用流式细胞仪进行DNA倍体分析,观察其细胞凋亡的变化规律。结果乐果中毒后,未治疗组大鼠很快出现流涎、肌肉颤动、呼吸困难、抽搐,最后因呼吸衰竭死亡,给予氯磷定及阿托品治疗组均比单用阿托品组恢复快(P<0.01),大剂量氯磷定组比中、小剂量氯磷定组恢复快(P<0.01),中剂量氯磷定组比小剂量氯磷定组恢复快(P<0.01)。各染毒组肝脏均出现明显病理变化,治疗组中以阿托品组病变最重,大剂量氯磷定组病变最轻。各治疗组肝脏均存在细胞凋亡,凋亡率在第2天达到高峰,单用阿托品组凋亡峰值最高,大剂量氯磷定加阿托品组最低。结论乐果中毒大鼠肝细胞存在细胞凋亡,治疗量肟类复能剂本身不加重肝功能损害,故肟类化合物是治疗急性有机磷中毒必不可少的药物。Objective To examine the treatment effectiveness of various doses of PAM-CL and on hepatic injury of acute Rogor poisoned rats. Methods 180 poisoned rats were divided into different groups; control group, untreated group, atropine group, and large, medial and small PAM-CL dose groups and atropine only group. Tissue pathology and ultrastructure changes were observed and flow cytometer was used to analyze DNA ploid and to evaluate the apoptosis procedures and changes. Results In the untreated group of the poisoned rats, wave shaped muscle trembles, dyspnea and convulsion occurred and all the rats in the group died of respiratory failure. Those using PAM-CL and atropine,when compared with the group using atropine only, showed lighter symptoms and quicker recovery（ P 〈 0.01 ）. The large dose group had quicker recovery than the medial dose group（P 〈0.01 ）, while the medial dose group had quicker recovery than the small dose group with later occurrence and lighter degree. The distinctly pathological changes showed in all groups. The group with atropine treatment was the most serious, and the group with large PAM-CL was lighter （P 〈0.01 ）. Hepatic pathological changes occurred in all the groups. The atropine group showed the most obvious change, while the large dose group showed the slightest. Apoptosis occurred in all the groups and apoptosis peak occurred on Day 2, with the atropine group reaching the highest peak. Conclusion Apoptosis of hepatic tissue cells occurred in all the poisoned rats. Oximes of therapeutical dose may not aggravate hepatic injury. Oximes are effective in the treatment of AOPP.

关 键 词：乐果 有机磷化合物 中毒 肝脏损害 氯磷定 治疗效果 动物 实验 

分 类 号：R595.4[医药卫生—内科学]