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  

Clinical significance of the dynamic changes of blood cholinesterase on patients with acute organophosphorus poisoning

作　　者：李春风[1] 赵金垣[2] 郭小刚[1] 孙绍莲 刘彦慧[1] 

机构地区：[1]河南卫辉市新乡医学院一附院,453100 [2]北京医科大学第三临床学院

出　　处：《中国急救医学》2000年第3期140-141,共2页Chinese Journal of Critical Care Medicine

基　　金：国家"九五"攻关课题!(国家科委编号 96 - 90 6 - 0 4 - 1 1 )临床研究部分内容

摘　　要：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 Studying the dynamic changes of whole blood cholinesterase (WBChE),Plasma cholinesterase (PChE) and erytherocyte cholinesterase(EChE) on patients with acute organophosporus poisoning(AOPP).Methods 49 Patients were treated with clearing poison ,5% sodium bicarbonate ,Jietin injection ,pralidoxime chloride and atropine ,WBChE,PChE and EChE on 49 cases were measured by peripheral blood before and after the treatment (at 6～12 hours ,24 hours ,48 hours ,72 hours and the time were discharged from hospital) the blood cholinesterase on 32 healthy cases were measure simnltaneously as the controls group Results WBChE and EChE on the poisoning patients were significantly decreased before and after theatment than those of the controls group ( P <0 01).ChE of the survival patients on middle ,serious AOPP was significantly decreased before treatment, the blood ChE was markedly decreased at 24 hours after treatment than those of controls group ,and increased slowly at 48 hours and it was lower at the time of discharged than those of the controls group respetively.ChE of two deadly patients were not increased continuously .PChE of patients was fluctuated ,distribotion dispersed ,and it regained faster than WBChE and EChE.Conclusions WBChE and EChE were increased slowly after were inhibited ,and were lower than those of controls group after were cured the dynamic observation on ChE is helpful for the prediction of the tendency of the disease and prognisis ,and it is valuable for the treatment. [

关 键 词：胆碱酯酶 活性值 有机磷中毒 

分 类 号：R595.4[医药卫生—内科学]