有机磷中毒中间综合征患者全血胆碱酯酶的变化及意义  

Changes and significance of blood cholinesterase in severe acute organophosphate poisoning with intermediate syndrome

作　　者：钱晨[1] 刘步云[1] 朱保锋[1] 张劲松[2] 

机构地区：[1]南通市第一人民医院急诊科,江苏省226001 [2]南京医科大学第一附属医院急诊科

出　　处：《江苏医药》2013年第22期2683-2685,共3页Jiangsu Medical Journal

摘　　要：目的探讨有机磷中毒(AOPP)中间综合征(IMS)患者全血胆碱酯酶(ChE)的变化及临床意义。方法 AOPP患者235例分为轻度、中度及重度中毒三组,并又分为有IMS和无IMS两个亚组,比较入院时ChE水平和相关资料。结果随着AOPP程度加重,入院时ChE水平降低,PSS评分及APACHEⅡ评分显著增高,IMS发病率及病死率也显著增高。IMS组与非IMS组PSS评分、APACHEⅡ评分和ChE水平无统计学差异。非IMS组入院4h后ChE开始增高,入院96h后恢复至正常的70%;IMS组患者入院24h内ChE变化不明显,其后缓慢上升,但显著低于非IMS组。结论入院4h内ChE变化不明显或96h内上升缓慢的重度AOPP患者容易发生IMS。Objective .To investigate the changes and clinical significance of blood cholinesterase（ChE） in severe acute organophosphate poisoning（AOPP） with intermediate syndrome （IMS）. Methods On the basis of the severity, 235 AOPP patients were divided into three groups of mild,moderate and severe, which were subdivided to groups of IMS（with IMS） and NIMS（without IMS）. Blood ChE on admission and data related were compared. Results As the severity of AOPP increased, blood level of ChE decreased and PSS and APACHE Ⅱ scores increased with increased incidence rate and mortality of IMS. There were no significant differences in blood ChE and PSS and APACHE Ⅱ scores between groups of IMS and NIMS. Blood level of ChE in group NIMS began to rise within 4 hours after admission and returned to 70% of the normal in 96 hours after admission. Blood level of ChE in group IMS was not significantly changed within 4 hours after admission and then was increasing gradually but was not as quick as that in group NIMS. Conclusion The IMS occurs easily in severe AOPP patients, in whom blood level of ChE is not significantly changed within 4 hours after admission or it is rising slowly within 96 hours.

关 键 词：急性有机磷中毒 中间综合征 胆碱酯酶 

分 类 号：R136[医药卫生—劳动卫生]