100例拟除虫菊酯类农药中毒患者的胆碱酯酶数值分析

Analysis of cholinesterase content in 100 pyrethriods pesticide poisoning cases

目的研究拟除虫菊酯类农药中毒患者是否存在胆碱酯酶的降低,探讨拟除虫菊酯类农药中毒的治疗方案。方法 100例拟除虫菊酯类农药中毒患者为中毒组,100例排除肝脏疾病及肝脏中毒的患者为对照组。观察不同年龄、不同服毒剂量患者之间胆碱酯酶数值变化的差异。结果对照组患者无一例胆碱酯酶降低;中毒组患者中69例胆碱酯酶正常,31例患者发生胆碱酯酶降低,占总中毒患者的31%,与对照组发生胆碱酯酶降低情况比较差异具有统计学意义(P<0.05)。中毒组中青年组有38例,中老年组有62例。中毒患者青年组患者中有10例患者发生胆碱酯酶降低,占本年龄段的26.3%;中老年组中有21例患者胆碱酯酶降低,占本年龄段的33.9%。青年组及中老年组患者发生胆碱酯酶降低情况比较差异无统计学意义(P>0.05)。中毒组中小量服毒患者有26例,中量服毒患者有47例,大量服毒患者有27例。不同服毒剂量患者的胆碱酯酶程度比较差异无统计学意义(P>0.05)。结论部分拟除虫菊酯类农药中毒患者也会发生胆碱酯酶降低,且这种降低与中毒存在一定相关性。此类中毒的乙酰胆碱蓄积表现不及有机磷农药中毒患者明显,在治疗上也与有机磷农药中毒有很大差别。

Objective To research whether there is a reduction of cholinesterase content in pyrethriods pesticide poisoning patients, and to investigate treatment scheme for pyrethriods pesticide poisoning. Methods There were 100 patients with pyrethriods pesticide poisoning as poisoning group, and 100 patients without hepatic disease and hepatic poisoning as control group. Differences of cholinesterase content were observed in patients with different ages and poisoning dosage. Results There was no case with decreased cholinesterase in the control group, while there were 69 cases with normal cholinesterase and 31 cases with decreased cholinesterase in the poisoning group, which accounted for 31% of total poisoning cases. Comparing with the control group, the poisoning group had statistically significant difference of decreased cholinesterase content（P〈0.05）. The poisoning group was further divided into youth group with 38 cases and middle and old age group with 62 cases. In youth group, there were 10 cases with decreased cholinesterase, accounting for 26.3% in this group. In middle and old age group, there were 21 cases with decreased cholinesterase, accounting for 33.9% in this group. There was no statistically significant difference of decreased cholinesterase between youth group and middle and old age group（P〉0.05）. There were 26 cases with small poisoning dose, 47 cases with moderate poisoning dose and 27 cases with huge poisoning dose in the poisoning group. There was no statistically significant difference of cholinesterase contents in different poisoning dose cases（P〉0.05）. Conclusion Some of pyrethriods pesticide poisoning patients may show decreased cholinesterase, which is correlated with poisoning. Acetyl choline accumulation in pyrethriods pesticide poisoning is less obvious than organophosphorus pesticide poisoning, and it requires remarkably different treatment as well.