AOPP病人血清ChE、CK-MB和LDH活性的变化

THE CHANGES OF ENZYMATIC ACTIVITY OF ChE,CK-MB AND LDH IN PATIENTS WITH ACUTE ORGANOPHOSPHORUS PESTICIDE POISONING

目的 探讨急性有机磷农药中毒（AOPP）病人血清胆碱酯酶（ChE）、肌酸激酶同工酶（CK—MB）、乳酸脱氢酶（LDH）活性变化及其意义。方法 检测38例重度AOPP病人人院第1、3、7天血清ChE、CK—MB和LDH活性，以10例健康成人作为对照。结果 与对照组比较，AOPP组病人血清ChE降低，CK—MB、LDH升高，差异有显著性（F=142．515～513．542，q=4．505～42．764，P〈0．05、0．01）；与第1天比较，人院第3天、第7天AOPP组病人血清ChE升高，CK—MB、LDH降低，差异有显著性（q=17．665～45．655，P〈0．05、0．01）。随治疗进展，血清ChE、CK—MB和LDH活性呈逐渐恢复趋势。结论 血清ChE水平不能作为临床评价有机磷农药中毒程度的有效指标，而CK—MB和LDH可作为有机磷农药中毒程度、病情和预后的判断指标。

Objective To investigate the changes of enzymatic activity of serum ChE, CK-MB and LDH in patients with AOPP and their clinical significance. Methods The activity of serum ChE, CK-MB and LDH was determined in 38 patients with AOPP on day 1, 3 and 7 after admission. Ten healthy people served as normal controls. Results Compared with the control group, the serum concentration of ChE was significantly reduced, and that of CK-MB and LDH were significantly increased in patients withAOPP （F=142.515-513.542;q=4.505-42.764;P〈0.05, 0.01）. Within the patient group, the serum ChE was significantly higher, and that of CK-MB and LDH were lower on day 3 and day 7 than on day 1 （q=17. 665-45. 655;P〈0.05, 0.01）. After treatment, the serum concentration of three enzymes gradually became normal. Conclusion Serum level of ChE is not an effective parameter for evaluating the degree of poinsoning of AOPP, while CK-MB and LDH can be used to judge its and predict its prognosis.