全血胆碱酯酶对急性有机磷农药中毒患者病情评估的价值  

The Value of Whole Blood Cholinesterase in Assessing the Condition of Patients with Acute Organophosphorus Pesticide Poisoning

作　　者：陈宏 翟金健 刘娟 CHEN Hong;ZHAI Jin-jian;LIU Juan(ICU,Sheyang County People’s Hospital,Sheyang,Jiangsu Province,224300 China)

机构地区：[1]江苏省射阳县人民医院重症医学科,江苏射阳224300

出　　处：《中外医疗》2017年第30期83-85,共3页China & Foreign Medical Treatment

摘　　要：目的探讨分析急性有机磷农药中毒患者采用全血胆碱酯酶(ACh E)以及血清丁酰胆碱酯酶(Bu Ch E)评估病情的临床价值。方法方便选取该院2011年2月—2017年6月收治的91例急性有机磷农药中毒患者作为该次实验研究对象,抽取患者入院8 h内、第2、3、4、5、6、7、8天同时段外周血检测患者ACh E活力,并分析ACh E和患者中毒程度的关系。结果轻度、中度、重度中毒患者8 h内Bu Ch E活力分别为(1 821.47±657.27)、(1 107.05±552.65)、(241.19±223.36)U/L。患者中毒程度越深,Bu Ch E的活力越下降,差异有统计学意义(P<0.05)。轻中度患者的中毒指数和Bu Ch E、ACh E活力指标均是负相关(r=-0.948、-0.919、-0.891、-0.899,P<0.05),BUCh E和ACh E呈正相关性(r=0.881、0.921,P<0.05)。中毒指数和BUCh E活力、ACh E活力之间呈负相关性(r=-0.921、-0.920,P<0.05),ACh E活力和BUCh E活力之间是正相关性(r=0.892,P<0.05)。结论早期急性有机磷农药中毒诊断中可采用血清Bu Ch E活力指标,患者经过治疗后临床症状和血清Bu Ch E活力恢复紧密相关。Objective This paper tries to evaluate the clinical value of whole blood cholinesterase(AChE)and serum butyryl cholinesterase(BuChE)for patients with acute organophosphorus pesticide poisoning.Methods 91 cases of acute organophosphorus pesticide poisoning in this hospital from February 2011 to June 2017 were convenient selected and were extracted by the hospitalized tim e within 8 h,the 2,3,4,5,6,7,8 d at the same tim e of patients with peripheral blood detection AChE vitality,and the relationship of AChE and poisoning degree were analyzed.Results The activity of BuChE in m ild,m oderate and severe poisoning patients was(1 821.47±657.27),(1 107.05±552.65),(241.19±223.36)U/L respectively.The higher the degree of poisoning,the more the activity of BuChE decreased,the difference was statistically significant(P<0.05).The m ild and m oderate poisoning index were negatively related to the BuChE and A C hE(r=-0.948,-0.9 1 9,-0.8 9 1,-0.899,P<0.05),BUChE and AChE were positively correlated(r=0.881,0.921,P<0.05),and the toxicity index of BUChE and AChE was negatively correlated(r=-0.9 21,-0.9 2 0,P<0.05).There was a positive correlation betw een AChE activity and BUChE activity(r=0.892,P<0.05).Conclusion The serum BuChE vigor index can be adopted in the early diagnosis of acute organophosphorus pesticide poisoning,after treatm ent,clinical symptoms and serum BuChE energy recovery of patients are closely related.

关 键 词：急性有机磷农药中毒 全血胆碱酯酶 病情评估 临床价值 

分 类 号：R595[医药卫生—内科学]