急性有机磷农药中毒患者血细胞数Hb和CRP浓度的变化及意义

Changes of blood cell, hemoglobin and C-reactive protein in the patients with acute organic phosphorus intoxication and its clinical meaning

目的 探讨急性有机磷农药中毒患者血细胞数、血红蛋白和C -反应蛋白浓度的变化及临床意义。方法 把35例中毒患者分为轻、中和重度中毒 3组 ,在入院 1、3、7d分别采集静脉血 4mL ,作红细胞 (RBC)、血红蛋白 (Hb)、白细胞(WBC)、中性粒细胞 (N)、血小板 (PLT)及C -反应蛋白 (CRP)浓度检测。并与对照组进行对比分析。结果 各中毒组第 1日检测上述各项指标均有不同程度的升高 ,且中毒越重 ,升高越显著 ;中毒第 3日 ,各中毒组RBC数和Hb浓度均明显下降 ,随中毒的严重程度而下降更显著。PLT数则随中毒程度而明显升高 ,中、重度中毒组与对照组比较差异显著 (P <0 .0 1或P <0 .0 0 1) ;WBC、N和CRP浓度随中毒的程度而显示不同的变化 ,中度中毒组较中毒第 1日有所下降 ,而重度中毒组则呈现出上升趋势 ;中毒第 7日 ,中度中毒组除PLT和N仍显示升高外 ,其余各项均基本恢复正常 ;重度中毒组除RBC和Hb较第 3日更进一步降低外 ,其余各项呈上升趋势 ,与对照组比较差异显著 (P <0 .0 1或P <0 .0 0 1)。结论 对急性有机磷农药中毒患者动态观察血细胞数、Hb和CRP浓度的变化 ,对判定中毒程度和了解病情变化有重要临床意义。

Objective To study the changes of blood cell, hemoglobin and C-reactive protein in the patients with acute organic phosphorus intoxication and its clinical meaning.Methods 35 patients were divided into three groups: mild, middle and severe. On the lst, 3rd and 7th day after admission, 4 mL blood sample was taken to test red blood cell (RBC), hemoglobin (Hb),white blood cell (WBC), neutrophil (N), platelet (PLT) and C-reactive protein respectively, and compared with the control group. Results In all intoxication groups, the indices above became higher in various degree on the 1st day, the more severe the intoxication was, the more significant the increase was. RBC and Hb decreased apparently in all intoxication groups on the 3rd day, and the decrease followed the degree of intoxication. Compared with the control, platelet increased significantly, the changes of mild and severe group were more significant ( P<0.01 or P<0.001). WBC, N and CRP had different degree according to the degree of intoxication, which was lower in middle group than the first day, but which had a tendency of increase in severe group. On the 7th day, all the indices except PLT and N reverted to normal state in middle group. All the indices except RBC and Hb in the severe group had the tendency of increase and has obvious difference compared with control group. Conclusion Continuous observation of the changes of blood cell, Hb and CRP density of the patients with acute organic phosphorus intoxication has important clinical meaning to study the degree of intoxication and the development of disease.