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目的探讨有机磷中毒(AOPP)中间综合征(IMS)患者全血胆碱酯酶(ChE)的变化及临床意义。方法 AOPP患者235例分为轻度、中度及重度中毒三组,并又分为有IMS和无IMS两个亚组,比较入院时ChE水平和相关资料。结果随着AOPP程度加重,入院时ChE水平降低,PSS评分及APACHEⅡ评分显著增高,IMS发病率及病死率也显著增高。IMS组与非IMS组PSS评分、APACHEⅡ评分和ChE水平无统计学差异。非IMS组入院4h后ChE开始增高,入院96h后恢复至正常的70%;IMS组患者入院24h内ChE变化不明显,其后缓慢上升,但显著低于非IMS组。结论入院4h内ChE变化不明显或96h内上升缓慢的重度AOPP患者容易发生IMS。
Objective To investigate the changes of whole blood cholinesterase (ChE) in patients with organophosphate poisoning (AOPP) intermediate syndrome (IMS) and its clinical significance. Methods AOPP patients 235 cases were divided into mild, moderate and severe poisoning three groups, and is divided into IMS and IMS-free two subgroups, compare ChE levels and related information on admission. Results With the increase of AOPP, the level of ChE decreased, the PSS score and APACHEⅡ score significantly increased, and the morbidity and mortality of IMS significantly increased. PSS score, APACHEⅡscore and ChE level in IMS group and non-IMS group had no statistical difference. After 4h admission, ChE began to increase in non-IMS group and returned to normal 70% after 96h admission. The change of ChE in IMS group was not obvious at 24h after admission, then increased slowly but was significantly lower than that in non-IMS group. Conclusions IMS is likely to occur in patients with severe AOPP within 4 hours after admission, or in patients with severe AOPP, whose changes of ChE are not obvious within 96 hours.