库存血液红细胞真性胆碱酯酶活力变化及其在重症有机磷农药中毒抢救中的意义

Changes of erythrocyte acetylcholinesterase activity and its significance in rescuing organophosphate intoxication patients

目的 观察库存血液保存时间与红细胞乙酰胆碱酯酶活力变化的关系 ,探索重症有机磷农药中毒、中间综合征抢救中换血疗法、输血的实验依据。方法 选取志愿供血者 10名 ,各抽取全血 2 0 0mL ,完全按库血条件保存 ;逐日每份抽取全血 1mL ,快速测定红细胞乙酰胆碱酯酶 (E -ACHE) ,重复 2 1d。测定采用便携式胆碱酯酶测定仪 (Biocheck)及其配套使用的试剂板。结果 库血随保存时间延长E -ACHE水平虽可以有所波动 ,但无显著下降 ,各组间方差分析均无显著性差异 (P >0 0 5 ) ,与对照组定基比波动于 92～ 98之间。库存血保存时间与E -ACHE直线回归方程无显著意义 (P >0 0 5 )。结论 本研究表明库血中的确含有一定量E -ACHE ,其活力随保存天数延长 ,2 1d内无明显下降。本研究结果为输血、换血治疗提供一定的实验依据 。

Objectives To investigate the relationship between the preservation days of banked blood and the activity of erythrocyte acetylcholinesterase (AchE) and to investigate the experimental basis of blood exchange therapy and blood transfusion that were used for the treatment of severe organophosphate intoxication and intermediate syndrome. Methods 200 mL whole blood was collected from ten healthy volunteers and stored exactly by the standard of banked blood.1 mL whole blood was collected from each blood sample for quick assay of erythrocyte ACHE (E-ACHE). This procedure was repeated for 21 days. The assay was accomplished using portable cholinesterase analyzer(Biocheck)and reagent plate provided with the analyzer. Results Although E-ACHE level fluctuated as preservation days extended, no significant decrease was noted. No significant difference between groups was observed by using the analysis of variance (P>0.05). The relative ratio with fixed base fluctuated from 92 to 98. The linear regression equation of the preservation days of banked blood and E-ACHE was no statistically significant (P>0.05). Conclusions Certain amount of E-ACHE existed in banked blood. Its activity did not significantly decrease in 21 days. This study was of referential value for blood transfusion and blood exchange therapy.