动态监测急性有机磷中毒患者血浆β-内啡肽、内皮素、一氧化氮与肿瘤坏死因子变化及其临床意义  

The dynamic variations of β- endorphin, endothelins, nitrogen monoxide and tumor necrosis factor in plasma and their clinical significances in the course of acute organophosphorus pesticide poisoning

作　　者：张在其[1] 梁仁[1] 杨华喜[2] 彭巍[2] 李峰[2] 尹芙蓉[2] 易高[2] 王承志[2] 

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

出　　处：《广东药学院学报》2002年第4期326-329,共4页Academic Journal of Guangdong College of Pharmacy

基　　金：本课题为怀化市科委资助项目(990518)。

摘　　要：目的:研究血浆β-内啡肽(β-EP)、内皮素(ET)、一氧化氮(NO)与肿瘤坏死因子(TNF)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:72例AOPP患者分别在入院后即刻、中毒后6、12、24、48、72、96、120、144、168、192 h抽静脉血2 mL,测定β-EP、ET、NO与TNF,以30名健康者为对照。结果:①在68例治愈患者中,β-EP、ET、NO与TNF在轻、中、重三组均于入院后即刻非常显著性升高,于中毒后12 h达高峰,随后缓慢下降。β-EP恢复正常时间在轻、中、重三组分别为中毒后144h、168 h、192 h。ET恢复正常时间在轻、中、重三组分别为中毒后144 h、144 h、168 h。NO恢复正常时间在轻、中、重三组均为中毒后168 h。TNF恢复正常时间在轻、中、重三组均为中毒后192 h。②4例死亡者β-EP、ET、NO与TNF在入院后即刻均已非常显著性升高,在治疗过程中继续升高。结论:①血浆β-EP、ET、NO与TNF水平与AOPP中毒程度及病情转归相关。②血浆β-EP、ET、NO与TNF水平在治疗过程中稳定下降提示预后良好,而其持续升高提示预后不良。③采取相应措施降低β-EP、ET、NO与TNF水平可改变AOPP的预后。Objective: To study the dynamic variations ofβ- endorphin (β-EP), endothelins ( ET) , nitrogen monoxide ( NO) and tumor necrosis factor (TNF) in plasma and their clinical significiances in the course of acute organophosphorus pesticide poisoning ( AOPP) . Methods:72 patients with AOPP were enrolled in this study. Theirβ-EP,ET,NO and TNF were measured upon hospitalization and 6 h,12 h,24 h,48 h,72 h,96 h, 120 h,144 h, 168 h,192 h after poisoning respectively and compared with those of 30 healthy individuals. Results: ①The levels of β -EP,ET,NO and TNF from 68 patients who were cured were very significantly higher compared with those of healthy individuals upon hospitalization, with the peak values at 12h after poisoning in the mild, moderate and severe groups. The time when β- EP returned to normal level was at 144 h, 168 h and 192 h after poisoning respectively in the mild, moderate and severe groups. The time when ET returned to normal level was at 144 h,144 h and 168h after poisoning respectively in the mild, moderate and severe groups. The time when NO returned to normal level was all at 168h after poisoning in the mild, moderate and severe groups. The time when TNF returned to normal level was all at 192h after poisoning in the mild, moderate and severe groups. ② The levels of β - EP,ET,NO and TNF from 4 patients who died finally were very high upon hospitalization and continued to increase in the course of treatment. Conclusions:①The levels ofβ - EP、ET,NO and TNF are correlated with the severity and the patient's condition of AOPP. ②The levels ofβ - EP, ET, NO and TNF decrease gradually to display eusemia in the course of treatment, on the contrary, their levels increase gradually to display mal - prognosis ③ To decrease levels of β- EP,ET,NO and TNF with corresponding measures can alter the prognosis of AOPP.

关 键 词：有机磷农药中毒 Β-内啡肽 内皮素 一氧化氮 肿瘤坏死因子 

分 类 号：R595.4[医药卫生—内科学]