全血、血浆、红细胞胆碱酯酶活性在急性有机磷农药中毒病程中的变化及意义  

The changes of cholinesterase activity in whole blood,plasma and erythrocyte and their clinical significance in acute organophosphorus pesticide poisoning

作　　者：张在其[1] 梁仁[1] 黄韬[1] 杨华喜[2] 彭巍[2] 陈涤民[2] 尹芙蓉[2] 易高[2] 周玉淑[3] 

机构地区：[1]广东药学院,广州510224 [2]湖南省怀化市第二人民医院,418200 [3]北京协和医院急诊科,100730

出　　处：《中华急诊医学杂志》2001年第4期232-234,共3页Chinese Journal of Emergency Medicine

基　　金：湖南省怀化市科委资助项目 (No .990 5 18)

摘　　要：目的　研究全血、血浆及红细胞胆碱酯酶 (ChE)在急性有机磷农药中毒(AOPP)病程中动态变化及其临床意义。方法　 5 6例AOPP患者分别在入院后即刻、中毒后 6、12、 2 4、 48、 72、 96、 12 0h测定其全血、血浆、红细胞ChE活性 ,以 40名健康者为对照。结果5 3例治愈者各组各时刻全血、血浆、红细胞ChE较对照组显著降低 (P <0 0 1)。轻度和中、重度中毒组全血、血浆、红细胞ChE分别在中毒后 12、 2 4h降至最低 ,在中毒后 2 4、 48h已回升。轻度中毒组中毒后 12h和中、重度组中毒后 2 4h全血、红细胞ChE与中毒后 6h比较差异非常显著 (P <0 0 1) ,但与入院后即刻比较差异无显著性 (P >0 0 5 )。三组血浆ChE在此三个时刻比较差异无显著性 (P >0 0 5 )。 3例死亡者全血、血浆、红细胞ChE在入院后即刻已明显降低 ,在治疗过程中大都继续降低或偶有一过性回升后又再次持续降低。结论　全血、红细胞ChE变化与AOPP临床中毒程度及其病情变化呈正相关 ,可作为临床观察有效指标。血浆ChE变异系数大 。Objective To study the changes of whole blood cholinesterase(WBChE),plasma cholinesterase(PChE) and erythrocyte cholinesterase (EChE) and their clinical significance in acute organophosphorus pesticide poisoning(AOPP). Methods 56 patients with AOPP were enrolled in this study.Their WBChE,PChE andEChE were measured upon hospitalization and 6h,12h,24h,48h,72h,96h and 120h after poisoning and compared with those of 40 healthy persons.Results The WBChE,PChE and EChE from 53 patients who were cured were very significantly lower than those of healthy persons(P<0 01).The WBChE,PChE and EChE in the mild and the moderate/severe groups dropped to the lowest level 12h and 24h after poisoning and began to rise again 24h and 48h after poisoning .The WBChE and EChE 12h after poisoning in the mild group and 24h after poisoning in the moderate/severe groups were very significantly lower than those at 6h after poisoning(P<0 01),but no significant difference was found when compared with those immediately after hospitalization(P>0 05).The PChE in three groups showed no difference at 6h,12h and 24h after poisoning (P>0 05).The WBChE,PChE and EChE in three patients who died later were very low upon hospitalization and continued to decrease during the course.Conclusion The WBChE and EChE correlated with the severity of AOPP,and can be used as clinical indicators.The coefficient of variation of PChE is big,and can not reflect the severity and clinical changes of AOPP.

关 键 词：胆碱酯酶 有机磷农药中毒 全血 血浆 红细胞 CHE 

分 类 号：R595.4[医药卫生—内科学]