急性有机磷农药中毒患者红细胞参数的测定及意义

The clinical significance of red cell parameters in patients with acute organophosphorus pesticide poisoning

目的 :探讨急性有机磷农药中毒患者红细胞 (RBC)、血红蛋白 (Hb)、血细胞比容 (HCT)、平均红细胞体积 (MCV)、平均红细胞血红蛋白含量 (MCH)、平均红细胞血红蛋白浓度 (MCHC)、红细胞体积分布宽度(RDW)等参数的变化及临床意义。方法 :根据患者入院时中毒程度设轻、中、重度中毒 3组及健康对照组。对各中毒组 1、3、7日及重度中毒组 14日分别采静脉血作 RBC各项参数的动态观察。健康对照组门诊检测 1次。结果 :各项参数随中毒的严重程度而变化更显著 ,与对照组比较 ,如以 P<0 .0 5为差异有显著性 ,则轻度中毒组 3次 2 1项检测中有 3项差异显著 ,中度中毒组 3次 2 1项检测有 8项差异显著 ,重度中毒组 4次 2 8项检测有2 1项差异显著 (P<0 .0 5 ,P<0 .0 1和 P<0 .0 0 1)。结论 :急性有机磷农药中毒 RBC参数的变化与中毒程度有关 ,动态观察其变化 ,对了解病情 ,指导治疗有重要临床意义。

Objective:To study the clinical significance of changes in red blood cell (RBC),hemoglobin (Hb),hematocrit(HCT),mean corpscular volume(MCV),mean corpuscular hemoglobin (MCH),mean corpuscular hemoglobin concentration(MCHC),red cell volume distribution width(RDW) in patients with acute organophosphorus pesticide poisoning.Methods:Patients were divided into three groups according to the severity of intaxication:the mild,middle and severe groups.Healthy volunteers served as controls.Blood samples were collected to measure these red cell parameters on 1,3,7,and 14 days after poisoning respectively.Results:All parameters did significantly change along with the severity of poisoning.Compared with normal controls,3 out of 21 indexes were marked different in mild group ( P <0 05),8 out of 21 indexes in middle group ( P <0 01),and 21 out of 28 indexes in severe group ( P <0 001).Conclusions:These data indicate that changes in red cell parameters appear to be related to the severity of poisoning.Serial measurement of these parameters may be useful to monitor the clinical conditions and guide treatment for patients with acute organophosphorus pesticide poisoning.