急性有机磷农药中毒患者血浆和肽素表达的临床意义

Clinical significance of copeptin expression in patients with acute organic phosphorus pesticide poisoning

目的 探讨分析血浆和肽素（copeptin）水平在急性有机磷农药中毒（AOPP）患者表达的价值.方法 将甘肃省人民医院2011-01~2015-12收治的210例患者,依其临床表现及血清胆碱酯酶（ChE）表达水平分为轻、中和重度组,另选取70例健康者为对照组.采用ELISA法测定各组血浆和肽素含量,APACHEⅡ评分、心肌酶谱（CK-MB,LDH）、心肌肌钙蛋白I（cTnI）及血生化等指标含量.分析血浆和肽素在AOPP患者中表达的意义及与其他指标的相关性.结果 AOPP各组血浆和肽素含量均明显高于对照组（P〈0.05）,且随着中毒程度增加,血浆和肽素含量及APACHEⅡ评分值递增（P〈0.05）.死亡组和肽素含量和APACHEⅡ评分显著高于存活组（P〈0.05）.AOPP患者血浆和肽素含量与APACHEⅡ评分、CK-MB、LDH及cTnI均有明显的正相关关系（P〈0.05）.结论 血浆和肽素含量可作为判断AOPP患者严重程度及预后的一个重要指标.

To investigate the copeptin in evaluating the severity and prognosis of acute organic phosphorus pesticide poisoning.Methods A total of 210 patients with acute organic phosphorus pesticide poisoning were selected from Gansu provincial hospital between Jan.2011 and Dec.2016.And they were divided into mild group, moderate group and severe group in accordance with their clinical symptom and the level of AChE.Besides, 70 cases of health people were selected as the control group.Copeptin was detected by ELISA;and APACHEⅡ score, myocardial enzymes, cTnI and some blood biochemistry indexes were detected in the two groups.Results The acute organic phosphorus pesticide poisoning groups＇ copeptin content were more than control group, the difference was statistically significant（P〈0.05）.As the poisoning degree increased, the content of copeptin and APACHEⅡscores increased（P〈0.05）.Copeptin content and APACHEⅡscores in death group were higher than survive group（P〈0.05）.For acute organic phosphorus pesticide poisoning patients, copeptin content had positive correlation with APACHEⅡ scores, CK-MB, LDH and cTnI（P〈0.05）.Conclusion The blood copeptin can be an important indicator in evaluating the severity and prognosis of acute organic phosphorus pesticide poisoning.