Expression and characterization of a codon-optimized butyrylcholinesterase for analysis of organophosphate insecticide residues

Organophosphate insecticide residues on vegetable, fruit, tea and even grains are primary cause of food poisoning. Organophosphate compounds can cause irreversible inhibition of the activity of acetylcholinesterase and butyrylcholinesterase（BChE, EC 3.1.1.8）, which are both candidates for rapid detection of organophosphate pesticides. To develop an easy-tohandle method for detecting organophosphate pesticides using BChE, BChE from human was optimized according to the codon usage bias of Pichia pastoris and successfully expressed in P. pastoris GS115. The codon-optimized cDNA shared 37.3% of the codon identity with the native one. However, the amino acid sequence was identical to that of the native human butyrylcholinesterase gene（h BCh E） as published. The ratio of guanine and cytosine in four kinds of bases（（G＋C） ratio） was simultaneously increased from 40 to 47%. The recombinant hBChE expression reached a total protein concentration of 292 mg m L^–1 with an activity of 14.7 U m L^–1, which was purified 3.2×10^3-fold via nickel affinity chromatography with a yield of 68% and a specific activity of 8.1 U mg^–1. Recombinant hBChE was optimally active at pH 7.4 and 50°C and exhibited high activity at a wide pH range（〉60% activity at pH 4.0 to 8.0）. Moreover, it had a good adaptability to high temperature（〉60% activity at both 50 and 60°C up to 60 min） and good stability at 70°C. The enzyme can be activated by Li^＋, Co^＋, Zn^2＋ and ethylene diamine tetraacetic acid（EDTA）, but inhibited by Mg^2＋, Mn^2＋, Fe^2＋, Ag^＋ and Ca^2＋. Na^＋ had little effect on its activity. The values of h BChE of the Michaelis constant（Km） and maximum reaction velocity（Vm） were 89.4 mmol L^–1 and 1 721 mmol min^–1 mg^–1, respectively. The bim olecular rate constants（K_i） of the hBChE to four pesticides were similar with that of electric eel AChE（EeAChE） and higher than that of horse BChE（HoBChE）. All vlues of the half maximal inhibitory concentration of a substance（IC50） for hBChE were lower than those for HoBChE, but most IC50 for hBChE were lower than those for EeAChE except dichlorvos. The applicability of the hBChE was further verified by successful detection of organophosphate insecticide residues in six kinds of vegetable samples. Thus, hBChE heterologously over-expressed by P. pastoris would provide a sufficient material for development of a rapid detection method of organophosphate on spot and produce the organophosphate detection kit.

Parenteral Insecticide Injection for Suicidal Attempt:A Case Report

Poisoning by insecticides is a public health problem, particularly in developing countries. Insecticide poisoning may occur due to ingestion, inhalation or skin contact and is commonly associated with psychiatric illnesses. However, intramuscular injection of these chemicals is rare in the literature. In this report, we represent you a case of 35-year-old female who presented to our Emergency Department due to parenteral insecticide injection after an argument with her husband. A tender swelling was observed on the upper region of left upper extremity, underneath the shoulder. The patient did not develop any signs and symptoms of organophosphate poisoning and, after follow-up, the patient was discharged with total recovery. Even in the absence of systemic effects of OP, clinicians must be aware of possible complications of intramuscular injection of OPs such as cellulitis and abscess. We aimed to raise the awareness to this rare condition.

Biochemical indicators and the Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning:An observational prospective study

Objective:To study the value of some biochemical indicators and Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning.Methods:This was a hospital-based prospective,observational study.Various biochemical tests viz.complete blood count,random blood sugar,liver and renal function tests,creatine phosphokinase,and electrolytes were performed.Patients were assessed based on the Peradeniya Organophosphate Poisoning scale.All the patients were followed till the end point like recovery/death.Results:Out of the 100 patients,72%were males and 28%were females.The majority of the patients were farmers and 21 to 30 years of age.Suicidal was the most common manner(92,92%).Based on the Peradeniya Organophosphate Poisoning scale,47%were mild,34%moderate,and 19%severe.Serum creatinine,creatine phosphokinase,serum glutamic-oxaloacetic transaminase,serum glutamic pyruvic transaminase,and alkaline phosphatase levels showed a significant correlation with severity.Conclusions:Some biochemical indicators such as creatine phosphokinase,alkaline phosphatase can be used as prognostic markers of organophosphorus poisoning.The Peradeniya Organophosphate Poisoning scale can be used for assessing severity of the poisoning.

Clinical correlates of hypotension in patients with acute organophosphorus poisoning

BACKGROUND:The aim of the present study is to describe the clinical correlates of hypotension and its associated outcomes in patients with acute organophosphorus poisoning(AOPP).METHODS:In this retrospective cohort study,we analyzed data pertaining to 871 patients with AOPP who were treated at two hospitals.Data from hypotensive and non-hypotensive patients were compared to identify clinical correlates of hypotension.We also evaluated the association between clinical parameters(including hypotension)and in-hospital mortality.RESULTS:The incidence of hypotension in AOPP patients was 16.4%.Hypotensive patients showed signifi cantly higher in-hospital mortality(1.1%vs.39.9%,P<0.001).Advanced age(odds ratio[OR]1.25,95%confi dence interval[CI]1.08–1.44),history of diabetes(OR 2.65,95%CI 1.14–5.96),and increased white blood cell count(OR 1.06,95%CI 1.03–1.09),plasma cholinesterase(OR 0.91,95%CI 0.84–0.94),plasma albumin(OR 0.88,95%CI 0.85–0.92),serum amylase(OR 1.01,95%CI 1.01–1.02),and blood pH(OR 0.64,95%CI 0.54–0.75)were signifi cantly associated with hypotension.After adjusting for potential confounders,hypotension was associated with increased in-hospital mortality(hazard ratio 8.77–37.06,depending on the controlled variables).CONCLUSIONS:Hypotension is a common complication of AOPP and is associated with increased in-hospital mortality.Advanced age,history of diabetes,and changes in laboratory parameters were associated with hypotension in AOPP patients.

Duodenal perforation after organophosphorus poisoning: A case report

BACKGROUND Organophosphorus poisoning(OP)is one of the common critical conditions in emergency departments in China,which is usually caused by suicide by taking oral drugs.Patients with severe OP have disturbance of consciousness,respiratory failure,toxic shock,gastrointestinal dysfunction,and so on.As far as we know,the perforation of the duodenum caused by OP has not been reported yet.CASE SUMMARY A 33-year-old male patient suffered from acute severe OP,associated with abdominal pain.Multiple computed tomography scans of the upper abdomen showed no evidence of intestinal perforation.However,retrograde digital subtraction angiography,performed via an abdominal drainage tube,revealed duodenal perforation.After conservative treatment,the symptoms eased and the patient was discharged from hospital.CONCLUSION Clinicians should pay close attention to gastrointestinal dysfunction and abdominal signs in patients with severe OP.If clinical manifestation and vital signs cannot be explained by common complications,stress duodenal ulcer or perforation should be highly suspected.

Effects of Changtuoning and Xuebijing combined with hemoperfusion on serum inflammatory factors and myocardial enzymes in patients with acute severe organophosphorus poisoning

Objective:To investigate the effects of Changtuogning and Xuebijing combined with hemoperfusion on serum inflammatory factors and myocardial enzymes in patients with acute severe organophosphorus pesticide poisoning (AOPP).Methods: A total of 92 patients with acute severe AOPP who were admitted to our hospital from July 2015 to June 2018 were enrolled. All patients were divided into the observation group and the control group by randomized block method (n=46). The control group was treated with Changtuoning and Xuebijing, and the observation group was treated with Changtuoning and Xuebijing combined with blood perfusion. The clinical indexes, serum inflammatory factors, myocardial enzyme indexes, complications and adverse reactions were compared between the two groups.Results:The doses of atropine, recovery waking time, ChE recovery time and hospital stay in the observation group were significantly lower than those in the control group. The cure rate in the observation group was significantly higher than that in the control group (P<0.05). There was no significant difference between the two groups (P>0.05). The levels of TNF-α, IL-8 and IL-18 in the observation group were significantly lower than those in the control group (P<0.05). The levels of CK, CK-MB, LDH and AST in the observation group were significantly lower than those in the control group (P<0.05). The incidence of complications (intermediate syndrome, respiratory failure, pulmonary infection, pulmonary edema) in the observation group was significantly lower than that in the control group (P<0.05). The incidence of adverse reactions (myalgia, fatigue, digestive tract reaction, abnormal liver function) in the observation group was significantly lower than that in the control group (P<0.05).Conclusion:Changtuoning and Xuebijing combined with hemoperfusion have significant effects on patients with acute severe organophosphorus poisoning, which can effectively reduce inflammatory factors and improve myocardial enzyme index.

Acute Poisoning among Farmers by Chlorpyrifos: Case Report from Gaza Strip

Spraying of organophosphorus insecticides (OPI) using high volume technique may result in poisoning cases among farmers or inhabitants in the spraying zone. This study reported a case among farmers in Gaza Strip, Palestine and discussed the follow up treatments. Results showed sever fasciculation of tongue and all muscle, pinpoint pupils not reacting to light, losing consciousness and disoriented, irritability, followed by diarrhea, vomiting, and severe inhibition of acetyl choline esterase (ACHE). Irritability and low level of ACHE activity were the unique syndromes of this case. Management of the poisoning with Atropine injection was not successful treatment to cure the case. Treatment with Toxogonin as intravenous injection resulted in relieved the irritability of the poisoned case and cure the patient at the end point. During the six weeks of follow up period, the case was severely poisoned in the 1st week, moderate poisoned in the 2nd week and slightly poisoned at the 3rd week. A medical decision to release the patient was made after ACHE activity level reached 4750 U/L, which very close to the normal range. The farmers left the hospital after three weeks of medical treatments and follow up. It is recommended to use Toxogonin in the management of poisoned cases with OPI immediately on arrival of cases with losing consciousness.

Insecticidal Activities of Alkaloids Extracted from Poisonous Plants

[Objective] Insecticidal activities of alkaloids extracted from 12 poisonous plants in Changbai Mountain were studied in the paper,to provide the basis for development and utilization of poisonous plants in Changbai Mountain.[Method] Leaf disc method was used to study the effects of alkaloids extracted from 12 poisonous plants on the growth and development of 3-5 instars of cabbage worm （Pieris rapae） and their antifeedant activities.[Result] The effects of alkaloids extracted from different poisonous plants on the growth and development of cabbage worm were also different.Five treatments of alkaloids extracted from Sophora flavescens,Datura stramonium L.,Arisaema amurense Maxim.,Veratum dahuricum Loes.and Tripterygium regelii Spragne et Takeda made the weight of test insects gradually decrease and finally die;the alkaloid treatments of Pueraria lobata （Willd.） Ohwi,Aconitum kusnezoffii Reichb.,Cimicifuga dahurica （Turcz.） Maxim.and Corydalis ambigua Schleeht.could make cabbage worm pupate ahead of time,but the pupa state was deformed;the antifeedant rates of cabbage worm after the treatments of P.lobata,A.kusnezoffii,C.dahurica,A.amurense,V.dahuricum and C.ambigua for 48 h were all over 90%,and the antifeedant rates of C.dahurica and C.ambigua were the highest as 100%.[Conclusion]The reports on the insecticidal activities of five poisonous plants including P.lobata,A.kusnezoffii,C.dahurica,C.ambigua and A.amurense are rare,and they have important values on the development of botanical pesticides.

Successful Management of Carbamate Poisoning among Children: Case Report from Gaza Strip

A bad management of pesticide marketing and use resulted in using extreme toxic pesticides inside houses for controlling public health insects such as cockroaches. A child of two years old was poisoned with pesticide residues after application of pesticides at home for cockroach control. The child with a semi-conscious status was brought to the European hospital in south Gaza with his father along with the empty container of pesticide which was used at home. It appeared that Carbaryl (a carbamate insecticide) was the reason for poisoning. In the intensive care unite the child was washed out with clean water and his cloths were removed to reduced the possible hazards. Blood analysis showed that moderate inhibition of acetylcholinesterase (AChE) on addition became more sever on due time. Then the child was given several doses of atropine but without any improvement in AChE activity. Then the child was given Obedoxim as an antidote. This resulted in significant improvement of AChE activity. The child continued to receive Obedoxim every day until AChE activity reached the normal range. Blood analysis did not show any traces of Carbaryl. It is recommended to give Obedoxim to the carbamate immediately when someone is poisoned instead of atropine for successful management of the poisoned case.

Metal Nano Layer Coating for Improving the Detection and Recognition of Micro-Poisons Using Reflection Spectroscopic Measurement

Metal nano layer coating for increasing the sensitivity of spectroscopic measurements is proposed and experimentally demonstrated in this paper. The metal nano layer will attract the micro-poisons from any measured aqueous sample increasing the concentration of the micro-poison in the vicinity of the surface and significantly improves the sensitivity of the spectroscopic measurement. The demonstration was carried out using Fourier Transform Infra-Red (FTIR) operating in the MIR 400 cm-1 - 4000 cm-1 and 5 nm Gold layer which was grown on silicon oxide substrate. In the experimental demonstration Malathion organophosphate pesticide was used as micro-poison. The spectroscopic measurement proves that Malathion was attracted to the metal nano layer. Furthermore, the absorption lines of Malathion were detected and recognized. This proof of principle can be applied to any Internal Reflection Elements (IRE) and it can be used to purify any aqueous solutions and atmosphere from micro-poisons which will be attracted to the metal Nano layer.

Current resistance status of Aedes aegypti and Aedes albopictus populations in Penang Island,Malaysia

Objective:To determine the current insecticide resistance status of Aedes(Ae.)aegypti and Ae.albopictus to four insecticides,namely 0.05%deltamethrin,0.75%permethrin,5%malathion and 0.25%pirimiphos-methyl using the World Health Organisation(WHO)susceptibility test kit.Methods:Adult bioassays were carried out using the standard protocol of the World Health Organisation.All F1 generation urban and suburban field strains of Ae.aegypti and Ae.albopictus were tested against pyrethroid and organophosphate insecticides,including the presence of piperonyl butoxide(PBO)in four replicates of 25 non-blood-fed female mosquitoes ranging from 3 to 5 days old.The Vector Control Research Unit(VCRU)laboratory strain served as a reference strain.Results:In this study,0.05%deltamethrin demonstrated a lower value of knockdown time when 50%of the mosquito population died(KT50)and knockdown time when 95%of the mosquito population died(KT95),which is significantly more effective compared to 0.75%permethrin against adult female Ae.aegypti(urban and suburban)and Ae.albopictus(urban and suburban)(ANOVA,P<0.01).Meanwhile,5%malathion was a more effective insecticide,amounting to the shorter KT50 and KT95 compared to 0.25%pirimiphos-methyl against Ae.aegypti(urban and suburban)and Ae.albopictus(urban and suburban).Ae.aegypti urban and Ae.aegypti suburban performed a higher resistance ratio(RR)towards both 0.05%deltamethrin and 0.75%permethrin due to the wide use of permethrin in dengue vector control programs in Malaysia.However,Ae.albopictus urban and suburban have lower resistance than Ae.aegypti urban and suburban towards 0.05%deltamethrin and 0.75%permethrin at 24 hours post-treatment.The addition of PBO with these insecticides successfully reduced knockdown time(KT50 and KT95)values of most of the Ae.aegypti and Ae.albopictus field strains except PBO+0.75%permethrin against Ae.aegypti suburban.Conclusions:The addition of PBO to insecticides has significantly reduced the knockdown time(KT50 and KT95)values on most of Ae.aegypti and Ae.albopictus urban strain except PBO+5%malathion against Ae.albopictus urban strain and PBO+0.75%permethrin against Ae.albopictus suburban strain in comparison to exposure to insecticides without PBO.Ae.aegypti showed a higher resistance ratio of 50(RR50)when compared with the VCRU laboratory reference strain(susceptible strain)at the exposure to the deltamethrin,including with pre-exposure to PBO.This study found that the addition of PBO with organophosphates(5%malathion and 0.25%pirimiphos-methyl)was significantly more effective than pyrethroids against Ae.aegypti and Ae.albopictus(urban and suburban)due to their high mortality rate at 24 hours.It can be concluded that the usage of PBO can help reduce resistance alteration in Aedes mosquitoes.

斜纹夜蛾谷胱甘肽S-转移酶SlGSTS4对拟除虫菊酯和有机磷类杀虫剂代谢和抗氧化活性

【目的】探究斜纹夜蛾Spodoptera litura谷胱甘肽S-转移酶SlGSTS4在拟除虫菊酯和有机磷类杀虫剂抗性中的作用。【方法】构建pET-26b(+)/SlGSTs4表达载体,将其在大肠杆菌Escherichia coli中异源表达,获得SlGSTS4重组蛋白,测定其对模式底物1-氯-2,4-二硝基苯(1-chlom-2,4-dinitrobenzene,CDNB)的米氏常数(K_(m))和最大反应速度(V_(max));采用超高效液相色谱(ultra-performance liquid chromatography,UPLC)测定重组蛋白SlGSTS4和表达SlGSTS4的大肠杆菌对拟除虫菊酯类杀虫剂(氰戊菊酯、高效氯氰菊酯和功夫菊酯)和有机磷类杀虫剂(毒死蜱和辛硫磷)的代谢率,并通过滤纸片抑菌圈试验测定SlGSTS4在过氧化氢异丙苯胁迫下的抗氧化活性。【结果】重组蛋白SlGSTS4对CDNB的V_(max)和K_(m)值分别为(13.8±2.3)nmol/(min·mg)和(1.66±0.1)mmol/L。UPLC结果表明,与对照相比,SlGSTS4重组蛋白仅对功夫菊酯有一定的代谢率(4.9%),而对氰戊菊酯、高效氯氰菊酯、辛硫磷和毒死蜱无代谢活性;转化SlGSTS4的大肠杆菌对氰戊菊酯、高效氯氰菊酯、功夫菊酯、毒死蜱和辛硫磷的代谢残留量峰面积均无明显变化,并且可以显著降低抑菌圈直径。【结论】SlGSTS4对拟除虫菊酯和有机磷类杀虫剂无直接代谢活性,具有明显的抗氧化活性。本研究结果丰富了对斜纹夜蛾GSTs Sigma家族基因的功能认知,有助于阐明SlGSTS4在斜纹夜蛾对拟除虫菊酯和有机磷类杀虫剂抗性中的功能。

血液灌流联合高通量血液透析对急性有机磷中毒患者心肌保护作用的影响

目的探讨对急性有机磷中毒患者给予血液灌流结合高通量血液透析对患者心肌功能保护的效果。方法选取莆田九十五医院2019年9月—2021年9月收治的60例急性有机磷中毒患者,随机分为对照组(n=30)与观察组(n=30)。2组患者入院后均给予常规治疗,对照组患者进行血液灌流治疗,观察组患者进行血液灌流联合高通量血液透析治疗。比较2组临床疗效、心肌损伤标志物、神经组织标志物及救治成功率和治疗满意度。结果观察组总有效率高于对照组(P<0.05)。2组患者治疗前血清肌钙蛋白I(cardiac troponin,cTnI)、肌酸激酶(creatine kinase,CK)、乳酸脱氢酶(lactate dehydrogenase,LDH)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)比较,差异无统计学意义(P>0.05);治疗后,2组cTnI、CK、LDH、CK-MB低于治疗前,且观察组低于对照组(P<0.05)。治疗后,2组胆碱酯酶(cholinesterase,CHE)高于治疗前,神经元特异性烯醇化酶(neuron-specificenolase,NSE)低于治疗前,且观察组CHE高于对照组,NSE低于对照组(P<0.05)。观察组救治成功率、总满意度依次为100%、96.67%,高于对照组的86.67%、76.92%(P<0.05)。结论急性有机磷中毒患者给予血液灌流结合高通量血液透析对患者心肌功能具有较好的效果,能有效改善患者的心肌损伤情况,并提升治疗的有效率和满意度。

6例虫螨腈中毒患者集束化急救护理的效果观察

目的观察集束化急救护理对虫螨腈中毒患者的疗效。方法回顾性分析6例虫螨腈中毒患者的救治及护理过程。结果6例虫螨腈中毒患者中,口服中毒5例,呼吸道及皮肤吸收毒物中毒1例。6例虫螨腈中毒患者均启动中毒救治绿色通道,开展多学科合作集束化治疗护理及毒物检测;1例毒物检测未检出虫螨腈成分,予以排除;余5例患者在初期均有不同程度的发热、乏力、恶心呕吐等症状,其中4例患者病程后期出现高热,意识障碍程度加重,在中毒后2~11 d治疗无效死亡(其中1例失联,预计死亡),病死率达80%。结论虫螨腈中毒无特效解毒剂,病死率极高;中毒后尽快留取患者血液、尿液等标本进行毒检,同时给予早期洗胃(6 h内)、肠道吸附、胃肠道导泄、灌肠等对症治疗,尽早行连续血液净化清除血液毒素,有条件者可行体外膜肺氧合治疗。

乌司他丁联合血液灌流对急诊有机磷中毒患者临床指标及肝肾功能的影响

目的探讨乌司他丁联合血液灌流对急诊有机磷中毒患者临床指标及肝肾功能的影响。方法选取我院收治的有机磷中毒患者60例,根据治疗方法不同分为参照组(30例,常规治疗+血液灌流)和观察组(30例,常规治疗+乌司他丁+血液灌流)。比较两组患者的临床指标(意识恢复时间、胆碱酯酶恢复时间)及肝肾功能。结果观察组意识恢复时间、胆碱酯酶恢复时间均短于参照组(P<0.05)。治疗7 d后,观察组的ALT、AST、Scr、BUN水平均低于参照组(P<0.05)。结论乌司他丁联合血液灌流治疗可明显缩短急诊有机磷中毒患者的意识恢复时间和胆碱酯酶恢复时间,改善其肝肾功能,值得临床推广应用。

"四位一体"急救护理流程救治急性有机磷中毒患者的应用效果

目的:探讨"四位一体"急救护理流程救治急性有机磷中毒患者的应用效果.方法:选取2018年5月至2022年10月本院急诊科收治的95例急性有机磷中毒患者作为研究对象.按照急救护理流程,将其分为观察组(n=48,采用"四位一体"急救护理)和对照组(n=47,采用常规急救护理).比较两组患者抢救相关指标水平、生活质量量表(GQOL-74)及存活率.结果:护理后,观察组患者用药时间、首次洗胃时间、中毒症状消失时间及胆碱酯酶恢复≥60%时间均短于对照组,差异均有统计学意义(P<0.05);观察组GQOL-74中心理、躯体、社会功能和物质生活评分均高于对照组,差异有统计学意义(P<0.05);观察组存活率(95.83%,46/48)高于对照组(82.98%,39/47),差异有统计学意义(P<0.05).结论:"四位一体"急救护理流程救治急性有机磷中毒患者可有效缩短救治时间,提高患者生活质量及存活率.

瘤胃投碘解磷定救治牛有机磷农药中毒的试验

为克服牛有机磷农药中毒救治过程中,部分患牛瘤胃冲洗困难造成硫酸阿托品用量大、疗程长的问题。将腾冲县12个乡镇339例牛有机磷农药中毒病例,分为对照组62例,按常规注射硫酸阿托品、碘解磷定和对症治疗;试验组277例,在对照组的基础上,用胃管投碘解磷定。结果显示,2组轻症的硫酸阿托品平均注射次数、总平均注射量差异显著(P<0.05);轻症的平均救治时间,重症和危症的硫酸阿托品平均注射次数、平均注射量、平均救治时间,差异极显著(P<0.01),而治愈率的差异不显著(P>0.05)。研究认为,及早给瘤胃投碘解磷定可大幅度提高牛有机磷农药中毒的抢救效率。

自动固相微萃取(SPM E)GC-MS、GC-MS-MS法检测环境水中有机磷杀虫剂的研究

固相微萃取(solid-phase microextraction,SPME)是20世纪90年代发展起来的一种样品前处理技术,与传统的液-液提取、液-固提取相比,SPME更适用于提取、浓缩液态或气态的挥发性和半挥发性物质,SPME技术可将采样、萃取、浓缩和样本引入集中于一个步骤完成,尤其随着自动SPME与GC-MS等联用技术的日益完善,使SPME技术优点得到更充分的发挥.……

集束化救治原则在急性有机磷中毒患者救治中的应用效果

目的探讨集束化救治原则在急性有机磷中毒患者中的应用效果。方法选取2015年2月至2018年8月于重庆市开州区人民医院接受救治的80例急性有机磷中毒患者作为研究对象,随机分为对照组与观察组,每组40例。对照组给予常规救治,观察组给予集束化救治。比较两组救治成功率、救治时间、治疗前后肝肾功能。结果观察组救治成功率为92.50%,高于对照组的75.00%,差异有统计学意义(P<0.05)。观察组清洁消化道时间、阿托品使用时间和住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,两组血尿素氮(BUN)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平比较差异无统计学意义;治疗后,两组BUN、ALT、AST水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论集束化救治原则在急性有机磷中毒患者中的应用效果显著,可明显提高患者的救治成功率,缩短救治时间,促进肝肾功能恢复,具有良好的应用效果。

阿托品联合碘解磷定治疗急性有机磷农药中毒的效果及对胆碱酯酶的影响分析

目的探讨阿托品联合碘解磷定治疗急性有机磷农药中毒(AOPP)的临床效果及对胆碱酯酶(ChE)的影响。方法76例AOPP患者,按照救治使用到的药物不同进行分组,其中使用碘解磷定治疗的患者38例分入对照组,使用阿托品+碘解磷定治疗的患者38例分入观察组。对比两组患者昏迷时间、机械通气时间、住院时间、并发症发生情况、死亡情况以及治疗前后的ChE、肌酸激酶(CK)、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]。结果观察组患者昏迷时间、机械通气时间、住院时间均短于对照组(P<0.05)。治疗后,观察组ChE高于对照组,CK低于对照组(P<0.05)。观察组并发症发生率10.53%低于对照组的31.58%(P<0.05)。治疗后,观察组患者MDA低于对照组,SOD高于对照组(P<0.05)。观察组死亡率7.89%低于对照组的26.32%(P<0.05)。结论阿托品联合碘解磷定对AOPP患者有更为理想的救治效果,能够缩短患者的救治时间,并促进早期ChE、CK水平改善,有助于降低并发症的发生率,改善患者的氧化应激水平,使死亡率降低。