有机磷农药中毒患者血液中性粒细胞的变化及意义

Clinical meaning and change of neutrophils of blood in the patient with acute organic phosphorus intoxication

目的 探讨急性有机磷农药中毒 (AOPP)患者血液白细胞 (WBC)、中性粒细胞 (N)百分数及N形态学改变的临床意义。方法 根据患者入院时中毒程度设轻、中、重度中毒组及健康对照组。分别在入院后第 1、7天抽静脉血 1mL做WBC及分类计数 (包括N占WBC总数的百分数 ,N毒性指数及核棘突积分 ) ;健康对照组门诊采血一次做同样检测。结果 中毒第1天 ,除轻度中毒组WBC计数一项正常外 ,各中毒组上述各项均显著升高 (与对照组比较P <0 0 5和P <0 0 1 )。中毒第 7天 ,轻度中毒组除中毒指数 1项外 ,其余各项均恢复正常 ;中、重度中毒组则除中度中毒组WBC 1项外 ,其余各项均仍显著升高 (与对照组比较P <0 0 5和P <0 0 1 )。但中度中毒组中毒第 7天与第 1天比较 ,WBC、核棘突积分和中毒指数均有显著降低 (P <0 0 5和 P <0 0 1 ) ,而重度中毒组与中毒第 1天比较 ,各项指标均未见显著变化 (均 P >0 0 5 )。结论 AOPP患者血液中WBC计数、N百分数、N形态学改变及恢复的速度与中毒的严重程度有关 ,动态观察上述各项指标 ,对了解患者病情及转归 。

Objective To research the clinical meaning of the level of WBC,the percent and morphological change of neutrophils in the patients with acute intoxication of organic phosphorus poisoning.Methods The patients were divided into three groups: mild, moderate and severe group according to the degree of clinical symptoms during the admission. The health control group was also established. The day of 1st and 7th after admission,one milliliter renous blood samples were determined,including WBC,Ncount,N toxicity index and cell crest accumulate points.The same was done with the health control.Results WBC count of the mild intoxication group was normal,the level of above parameters in the moderate and severe group was dominantly higher than that in control on the 1st day (P<0 05,P<0 01).On the 7th day,the other parameters of the mild group all returned to normal except the toxicity index.The level of the other parameters of the moderate and severe group still remained significantly higher than that of the control (P<0 05,P<0 01),except WBC count of the moderate intoxication group.But compared with itself on the 1st day,all the parameters of moderate group became significantly low (P<0 05,P<0 01),and there was no evident change about the severe group parameters (P>0 05).Conclusion The increased level of acute intoxication of organic phosphorus intoxication was related with the degree of WBC,N count and N morphological change.Dynamic observation of the above index was of great help to understand the patients situation and recovery and to direct clinical therapy.