急性有机磷农药中毒患者血清肌酸激酶同工酶谷草转氨酶和乳酸脱氢酶的变化及其意义

Changes of serum creatine kinases,glutamic oxaloacetic transaminase and lactic dehydrogenase in patients with acute organophosphorus pesticide poisoning and its significance

目的：研究急性有机磷农药中毒（ＡＯＰＰ）对人体组织的损害机制。方法：对１６３例ＡＯＰＰ患者（轻中度中毒组７２例、重度中毒组７９例、呼吸麻痹组１２例）入院当日及此后每２４小时抽空腹静脉血测定血清肌酸激酶（ＣＫ）及其同工酶（ＣＫＭＢ）、谷草转氨酶（ＧＯＴ）和乳酸脱氢酶（ＬＤＨ）水平。结果：①轻中度中毒组血清ＣＫ及ＬＤＨ测值〔（３２８０．７±６５５．１）ｎｍｏｌ·ｓ－１·Ｌ－１及（２．８±０．７）μｍｏｌ·ｓ－１·Ｌ－１〕高于正常对照组〔（２４７２．２±３４５．１）ｎｍｏｌ·ｓ－１·Ｌ－１及（１．８±０．２）μｍｏｌ·ｓ－１·Ｌ－１〕，Ｐ＜０．０５和Ｐ＜０．０１。重度中毒组及呼吸肌麻痹组ＣＫ、ＣＫＭＢ、ＧＯＴ和ＬＤＨ水平〔（８２５６．７±６０８．５）ｎｍｏｌ·ｓ－１·Ｌ－１、（６０８．５±１８８．４）ｎｍｏｌ·ｓ－１·Ｌ－１、（８１０．２±１９４．２）ｎｍｏｌ·ｓ－１·Ｌ－１、（５．８±１．１）μｍｏｌ·ｓ－１·Ｌ－１及（３９４６６．２±５２１６．０）ｎｍｏｌ·ｓ－１·Ｌ－１、（２４７０．５±７４０．１）ｎｍｏｌ·ｓ－１·Ｌ－１、（１７８０．４±５８５．１）ｎｍｏｌ·ｓ－１·Ｌ－１、（１１．９±１．９）μｍｏｌ·?

Objective:To study the mechanism of human tissue damages caused by acute organo phosphorus pesticide poisoning (AOPP).Methods:Serum creatine kinase (CK),creatine kinase isoenzyme MB (CKMB),glutamic oxaloacetic transaminase (GOT) and lactic dehydrogenase (LDH) in 163 patients with AOPP including light and middle degree poisoning group( n= 72),serious group( n= 79),respiratory muscle paralysis group( n =12) were measured while admitted in hospital and every 24 hour later.35 healthy people served as control group.Results:①Peak values of serum CK (3 280 7±655 1)nmol·s -1 ·L -1 and LDH (2 8±0 7)μmol·s -1 ·L -1 in light and middle degree group were significantly higher than those in controls respectively (2 472 2±345 1)nmol·s -1 ·L -1 and (1 8±0 2)μmol·s -1 ·L -1 , P <0 05 and P <0 01.The values of all serum CK,CKMB,GOT and LDH in serious group (8 256 7±608 5)nmol·s -1 ·L -1 ,(608 5±188 4)nmol·s -1 ·L -1 ,(810 2±194 2)nmol·s -1 ·L -1 ,(5 8±1 1)μmol·s -1 ·L -1 and respiratory muscle paralysis group (39 466 2±5 216 0)nmol·s -1 ·L -1 ,(2 470 5±740 1)nmol·s -1 ·L -1 ,(1 780 4±585 1)nmol·s -1 ·L -1 ,(11 9±1 9)μmol·s -1 ·L -1 were significantly higher than those in control group (2 472 2±345 1)nmol·s -1 ·L -1 ,(208 4±96 7)nmol·s -1 ·L -1 ,(408 4±205 0)nmol·s -1 ·L -1 ,(1 8±0 2)μmol·s -1 ·L -1 , P <0 01 .Peak values of the four serum enzymes in respiratory muscle paralysis group were 46 times in control group and were significantly higher than those of serious group, P <0 01.②Serum CK,CKMB,GOT and LDH in AOPP patients showed a regularly tendency changes and had a higher platform on 2nd to 5th days.Conclusions:This study showed that the more severe the AOPP was,the more significant the enzymes increased,reflecting the more severe in the tissue damaged.On 2nd to 5th days the tissue injury was more severe.