急性有机磷农药中毒患者血清及全血胆碱酯酶的相关性研究  

Correlation between serum and whole blood cholinesterase in patients with acute organophosphorus pesticide poisoning

作　　者：高茹春 赵建娅 潘爱群 李涛 

机构地区：[1]河北省唐山市工人医院急救中心,河北唐山063000

出　　处：《重庆医学》2016年第5期648-650,共3页Chongqing medicine

摘　　要：目的探讨急性有机磷农药中毒患者血清及全血胆碱酯酶的相关性。方法选择该院收治的有机磷农药中毒患者79例作为观察组,另选取40例健康老年体检者作为对照组。79例患者均使用复能剂治疗,维持生命体征平稳。抽取患者入院8h以内及第2、3、4、5、6、7、8天和出院前1d同时段的外周血检测血清丁酰胆碱酯酶(BuChE)和全血乙酰胆碱酯酶(AChE)活力,同时进行中毒指数评估。结果对照组的BuChE活性明显高于轻、中、重度有机磷中毒患者(F=249.41,P<0.01)。轻、中度有机磷中毒患者入院第5天,中毒指数、血清BuChE、全血AChE活力3项指标改善明显,相关性分析显示中毒指数和全血AChE呈负相关(r=-0.95、-0.89,P<0.01);中毒指数和血清BuChE呈负相关(r=-0.92、-0.90,P<0.01);血清BuChE和全血AChE呈正相关(r=0.87、0.91,P<0.01)。重度有机磷中毒患者入院后第8天,3项指标改善明显,相关性分析显示中毒指数和全血AChE呈负相关(r=-0.91,P<0.01);与血清BuChE呈负相关(r=-0.91,P<0.01);血清BuChE和全血AChE呈正相关(r=0.88,P<0.01)。结论血清BuChE活性可作为早期急性有机磷农药中毒诊断的敏感指标,治疗后患者血清BuChE活力的恢复和临床症状密切相关。Objective To study the correlation between serum and whole blood cholinesterase in the patients with acute organophosphorus pesticide poisoning.Methods 79 patients with organophosphorus pesticide poisoning in our hospital were selected as the observation group and 40 elderly peoples undergoing the healthy physical examination were selected as the control group.The patients were treated by the reactivation agents for maintaining the vital signs assessment.The peripheral blood was collected within8 hafter admission and at the same time period on 2,3,4,5,6,7,8dafter admission and on 1dday before discharge and detect serum butyrylcholinesterase（BuChE）and whole blood cholinesterase（AChE）activity,meanwhile the poisoning index was evaluated.Results The BuChE activity in the control group was significantly higher than that in the mild,moderate and severe patients with organophosphorus poisoning,the difference was statistically significant（F=249.41,P〈0.01）;the poisoning index,serum BuChE and whole blood AChE activities on 5dafter admission in the patients with mild and moderate organophosphorus poisoning were significantly improved,the correlation analysis revealed that the poisoning index was negatively correlated with the whole blood AChE activity（r=-0.95,0.89,P〈0.01）;the poisoning index was negatively correlated with serum BuChE（r=-0.92,-0.90,P〈0.01）;the serum BuChE was positively correlated with whole blood AChE activity（r=0.87,0.91,P〈0.01）.The poisoning index,serum BuChE and whole blood AChE activities on 8dafter admission in the patients with severe organophosphorus poisoning were significantly improved,the correlation analysis showed that the poisoning index was negatively correlated with whole blood AChE（r=-0.91,P〈0.01）;the poisoning index was negatively correlated with serum BuChE（r=-0.91,P〈0.01）;serum BuChE was positively correlated with whole blood AChE（r=0.88,P〈0.01）.Conclusion Serum BuChE activity can be used as a sensitive index in the early diagnosis of orga

关 键 词：急性有机磷农药中毒 全血胆碱酯酶活力 血清胆碱酯酶活力 

分 类 号：R595.4[医药卫生—内科学]