活性炭血液灌流对有机磷农药敌敌畏和解毒药阿托品的作用

The adsorption effect of hemoperfusion with activated charcoal on dichlorvos and atropine

目的评估活性炭血液灌流对有机磷农药敌敌畏和解毒药阿托品的作用。方法在人血样(由解放军307医院血库提供的正常人血样)中加入敌敌畏和阿托品后,分成空白对照组和血液灌流组,观察灌流前后血中敌敌畏浓度和阿托品浓度以及血清中胆碱酯酶活力的变化。结果活性炭血液灌流中敌敌畏和阿托品的吸附率分别为(0.98±0.05)%和(0.68±0.01)%。在混合吸附试验中,吸附后的阿托品和敌敌畏之比较吸附前浓度之比增加。同时,吸附后假性胆碱酯酶活力比吸附前增长了近3倍。结论虽然在体外人血中活性炭血液灌流对人血中敌敌畏的吸附率较低(与空白组比较,P>0.05),但大大提高了血清中胆碱酯酶活力,同时提高了血中阿托品和敌敌畏的浓度之比,从而更易到达阿托品化。

Objective To investigate the adsorption effect of hemoperfusion on with activated charcoal organophosphorus pesticide poisoning.Methods Dichlorvos and atropine were added into healthy fresh human blood provided by Affiliated Hospital of Military Medical Institution,and the poisoning blood were divided into two groups: control group and hemoperfusion treatment group.The following parameters were observed:dichlorvos concentration,atropine concentration,the pseudocholinesterase activity.Results The clearance rate of dichlorvos and atropine by hemoperfusion with activated charcoal were(0.98±0.05)% and (0.68±0.01)%,respectively. In the mixed adsorption tests, the ratio of atropine concentration to dichlorvos concentration after adsorption was increased compared with before adsorption.The pseudocholinesterase activity after adsorption was almost 3 fold compared with before adsorption.Conclusion Although the clearance rate of dichlorvos in human blood by hemoperfusion with activated charcoal was low, it could highly improve the pseudochlinesterase activity and improve the ratio of atropine concentration to dichlorvos concentration,which could achieve atropinization easily.