急性有机磷农药中毒患者全血胆碱酯酶和血清丁酰胆碱酯酶活力检测意义

Significance of Detection of Cholinesterase Activity in AOPP Patients' Serum and Whole Blood

目的:探讨急性有机磷农药中毒患者全血胆碱酯酶(ACh E)和丁酰胆碱酯酶(BUCh E)活力检测意义。方法:有机磷农药中毒患者79例于入院8 h以内、入院后第2、3、4、5、6、7、8天和出院前1 d进行中毒指数评估,同时抽取外周血比色法测定血清BUCh E活力和ACh E活力,分析中毒指数与ACh E、BUCh E相关性。结果:轻度、中度及重度中毒患者入院时BUCh E比较,差异无统计学意义(P<0.01);轻度、中度及重中毒患者入院8 h以内有明显中毒症状,轻、中度中毒患者于入院治疗后第5天,重度患者于入院后第8天,中毒指数、ACh E、BUCh E活力指标才明显改善,轻、中及重度中毒患者中毒指数与ACh E、BUCh E活力均呈负相关(r=-0.952、-0.921、-0.892、-0.902、-0.914、-0.918,P<0.01),BUCh E活力和ACh E活力呈正相关(r=0.875、0.915、0.889,P<0.01)。结论:BUCh E活力可作为急性有机磷农药中毒早期诊断指标之一。

Objective： To investigate the activity changes of eholinesterase in AOPP patients＇ serum and whole blood. Methods：A total of 79 cases of patients with acute organophosphorus pesticide poi- soning （AOPP） were retrospectively analyzed, of which 11 cases were mild, 21 cases moderate and 47 cases severe. 40 cases of healthy elderly people were also selected as control group. Poisoning indexes were detected and evaluated within 8 h, 2, 3, 4, 5, 6, 7, 8 days after admission and 1 day before discharge. Meanwhile, the peripheral blood was extacted to determine serum BUChE activity and AChE activity of the whole blood by chromometry. Results：The differences of BUChE in mild, moder- ate and severe organophosphate poisoning patients on admission were not statistically significant （P 〈 0. 01 ）. There were obvious symptoms in mild, moderate and severe organophosphate poisoning patients within 8 h of admission. 5 d after admission, poisoning index, serum BUChE activity and AChE activi- ty improved significantly for mild, moderate organophosphate poisoning patients while these indexes im- proved 8 d after admission for severe poisoning patients. Poisoning indexes in mild, moderate organo- phosphate poisoning were negatively correlated with serum BUChE activity and AChE activity （r = -0. 952, -0.921, -0.892, -0.902, -0.914, -0.918, P 〈0.01） while serum BUChE activity was positively correlated with AChE activity （r = 0. 875, 0.915, 0. 889, P 〈 0.01 ）. Conclusion：Ser- um BuChE activity can be one of early index of acute organophosphorus pesticide poisoning diagnosis.