微量动态监测有机磷中毒者全血、血浆、红细胞胆碱酯酶活性的临床研究  

Dynamic monitoring of cholinesterase activities in whole blood, plasma and erythrocyte in patients of acute organophosphorus pesticide poisoning and their clinical significance

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] 王承志[2] 周玉淑[3] 

机构地区：[1]广东药学院,广东广州510224 [2]湖南省怀化市第二人民医院 [3]中国医学科学院北京协和医院急诊科

出　　处：《广东药学院学报》2002年第2期145-148,共4页Academic Journal of Guangdong College of Pharmacy

摘　　要：目的 :采用自行研制的“快速微量动态监测法”研究全血、血浆及红细胞胆碱酯酶 (ChE)在急性有机磷中毒 (AOPP)病程中动态变化及其临床意义。方法 :72例AOPP患者分别在入院后即刻、中毒后 6、12、2 4、48、72、96、12 0h抽静脉血 2mL ,定量测定其全血、血浆、红细胞ChE活性 ,以 40名健康者为对照。结果 :68例治愈者各组各时刻全血、血浆、红细胞ChE较对照组有非常显著性降低 (P <0 .0 1)。轻度与中、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与中、重度组中毒后 2 4h全血、红细胞ChE与中毒后 6h比较差异有非常显著性 (P <0 .0 1)意义 ,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 )。 4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 :“快速微量动态监测法”切实可行 ,并具有微量、快速、简单、灵敏、稳定、精确及准确等特点 ,优于现行诸多ChE检测方法。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 dynamic variations of cholinesterase in whole blood (WBChE),plasma (PChE)and erythrocyte cholinesterase(EChE) and their clinical significiance in the course of acute organophosphorus pesticide poisoning(AOPP). Methods:72 patients with AOPP were enrolled in this study. Their WBChE, PChE and EChE were measured upon hospitalization and 6,12,24,48,72,96 h and 120 h after poisoning and compared with those of 40 healthy individuals Results:The WBChE, PChE and EChE from 68 patients who were cured were very significantly lower than those of healthy individuals( P <0.01) The WBChE , PChE and EChE in the mild and moderate severe groups dropped to the lowest levels 12 h and 24 h after poisoning respectively and began to rise 24h and 48h after poisoning respectively The WBChE and EChE 12h after poisoning in the mild group and 24h after poisoning in the moderate -severe group were very significantly lower than those of 6h after poisoning respectively( P <0.01), but no significant difference was found when compared with those of upon 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 4 patients who died later were very low upon hospitalization and continued to decrease during the course Conclusions:The dynamic monitoring method applied in this study is practical and has many advantages over other methods. The WBChE and EChE are correlated with the severity of AOPP,and can be used as a clinical indicator The variation coefficient of PChE is big,and can not reflect the severity and clinical changes of AOPP.

关 键 词：微量动态监测 有机磷中毒 全血 血浆 红细胞 胆碱酯酶活性 有机磷化合物 

分 类 号：R595.4[医药卫生—内科学]