高淀粉酶血症对重度急性有机磷农药中毒预后的影响

Effects of hyperamylasemia on prognosis of severe organophosphorus pesticide poisoning

目的研究高淀粉酶血症对重度急性有机磷农药中毒(AOPP)患者预后的影响。方法 58例重度AOPP患者根据入院时血清淀粉酶水平,将患者分为对照组、轻度高淀粉酶血症组、重度高淀粉酶血症组,观察各组急性呼吸衰竭、中间综合征IMS、反跳、迟发性多神经病变的发生率及预后。结果与对照组相比,轻度、重度高淀粉酶血症组急性呼吸衰竭、中间综合征、迟发性多神经病变发生率明显升高(P<0.05),反跳发生率差异无统计学意义(P>0.05),治愈率降低(P<0.05)。重度高淀粉酶血症组患者的急性呼吸衰竭、IMS发生率高于轻度高淀粉酶血症组(P<0.05),而两组患者反跳、迟发性多神经病变的发生率差异无统计学意义(P>0.05),治愈率差异亦无统计学意义(P>0.05)。结论合并血清淀粉酶升高的重度AOPP患者各种并发症的发生率增高(反跳除外)、治愈率降低,临床上应重视对患者血清淀粉酶水平的监测。

Objective To study the influence of hyperamylasemia on the poisoning. Methods Fifty-eight cases serum amylase level on admission, the of acute severe organophosphorus pesticid patients were divided into normal control prognosis of patients with severe organoph e poisoning were analyzed retrospectively. group, mild hyperamylasemia group and ospho^s pesticide According to the severe hyperamy- lasemia group. All the incidences of acute respiratory failure, intermediate syndrome, rebound, delayed polyneuropathy and the prognosis in each group were observed. Results Compared with the control group, the incidences of acute respiratory failure, intermediate syndrome, delayed polyneuropathy of mild and severe hyperamylasemia group were significantly higher （P 〈 0.05 ） , but the bounce rate showed no difference （P 〉 0.05 ）, and the cure rate was lower （ P 〈 0.05 ）. The incidences of acute respiratory failure and intermediate syndrome of se- vere hyperamylasemia group were higher than those of mild hyperamylasemia group （P 〈 0.05 ） , while the rebound incidence, delayed poly- neuropathy incidence and cure rate between the two groups had no significant differences （P 〉 0.05 ）. Conclusion Due to the conclusion of increased rate of complications （except rebound） and reduced cure rate in severe organic phosphorus pesticide poisoning patients with elevat- ed serum amylase, clinical doctors should pay attention to the monitoring of serum amylase level.