急性有机磷农药中毒早期血药浓度与生化及CD分子的关系及临床意义

The relationship between early blood drug concentration and biochemical and CD molecular and clinical significance in patients with acute organophosphorus pesticide poisoning

目的探讨急性甲胺磷农药中毒早期血药浓度与T淋巴细胞亚群的关系。方法选择2007年1月～2013年6月河北大学附属医院急诊医学科92例口服急性甲胺磷农药中毒患者为研究对象，根据中毒程度分为轻中度中毒组54例和重度中毒组38例，另选同期健康体检者92例为对照组，检测并分析两组患者血药浓度与CD3＋、CD95＋、CD3＋/CD23＋、CD8＋/CD28＋、CD8＋/CD28-的关系。结果重度中毒组血药浓度[（2．13±0．32）μmol／L]明显高于轻中度中毒组[（1．35±0．18）μmol／L]，差异有高度统计学意义（P〈0．01）；重度中毒组CD95＋、CD3＋/CD23＋、CD8＋/CD28＋明显高于轻中度中毒组（q=6．71、6．48、6．48，均P〈0．01）；重度中毒组CD3＋、CD8＋/CD28-明显低于轻中度中毒组（q=6．75、6．54，P〈0．05或P〈0．01）。结论急性甲胺磷农药中毒早期血药浓度越高，中毒程度愈重，免疫细胞受损越严重。

Objective To study the relationship between blood drug concentration and T lymphocyte subsets in early stage of acute Methamidophos poisoning. Methods 92 cases with acute oral Methamidophos pesticide poisoning from January 2007 to June 2013 in the Department of Emergency Medicine, Affiliated Hospital of Hebei University were se- lected as study objects, and they were divided into mild-to-moderate poisoning group （n = 54） and severe poisoning group （n = 38） according to the degree of intoxication, another 92 healthy control in the same term were selected as con- trol group, The relationship between the two groups of blood drug concentration and CD3＋, CD95＋, CD3＋/CD23＋, CD8＋/ CD28＋, CD8＋/CD28- were analyzed. Results The concentration of blood drug level of severe poisoning group [（2.13± 0.32） μmol/L] was significantly higher than that of the mild-to-moderate poisoning group [（1.35±0.18） μmol/L], the difference was statistically significant （P 〈 0.01）; the level of CD3＋, CD95＋, CD3＋/CD23＋, CD8＋/CD28＋, CD8＋/CD28- of severe poisoning group were higher than those of the mild-to-moderate poisoning group （q = 6.71, 6.48, 6.48; all P 〈 0.01）; the level of CD3＋ and CD8＋/CD28- of severe poisoning group were lower than those of the mild-to-moderate poisoning group （q = 6.75, 6.54,P 〈 0.05 or P 〈 0.01）. Conclusion The higher of the acute Methamidophos pesticide poisoning early blood drug concentration, the more serious of the poisoning degree and the immune cellular damage.