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目的 :采用自行研制的“快速微量动态监测法”研究全血、血浆及红细胞胆碱酯酶 (ChE)在急性有机磷中毒 (AOPP)病程中动态变化及其临床意义。方法 :72例AOPP患者分别在入院后即刻、中毒后 6、12、2 4、48、72、96、12 0h抽静脉血 2mL ,定量测定其全血、血浆、红细胞ChE活性 ,以 40名健康者为对照。结果 :68例治愈者各组各时刻全血、血浆、红细胞ChE较对照组有非常显著性降低 (P <0 .0 1)。轻度与中、重度中毒组全血、血浆、红细胞ChE分别在中毒后 12、2 4h降至最低 ,在中毒后 2 4、48h已回升。轻度中毒组中毒后 12h与中、重度组中毒后 2 4h全血、红细胞ChE与中毒后 6h比较差异有非常显著性 (P <0 .0 1)意义 ,但与入院后即刻比较差异无显著性 (P >0 .0 5 )。三组血浆ChE在此三个时刻比较差异无显著性 (P >0 .0 5 )。 4例死亡者全血、血浆、红细胞ChE在入院后即刻已明显降低 ,在治疗过程中大都继续降低或偶有一过性回升后又再次持续降低。结论 :“快速微量动态监测法”切实可行 ,并具有微量、快速、简单、灵敏、稳定、精确及准确等特点 ,优于现行诸多ChE检测方法。全血、红细胞ChE变化与AOPP临床中毒程度及其病情变化呈正相关 ,可作为临床观察有效指标。血浆ChE变异系数大 ,不能准确反映AOPP临床中毒程度及
OBJECTIVE: To study the dynamic changes of whole blood, plasma and erythrocyte cholinesterase (ChE) during the course of acute organophosphorus poisoning (AOPP) and its clinical significance by using “rapid microdynamic monitoring”. Methods: Seventy-two patients with AOPP were given 2 mL of venous blood immediately after admission, 6,12,2 4,48,72,96 and 120h after poisoning, and their serum, plasma and erythrocyte ChE activities were measured quantitatively. Forty healthy For the control. Results: The ChE of whole blood, plasma and erythrocytes of 68 cured patients were significantly lower than those of the control group at each time point (P <0.01). The levels of whole blood, plasma and erythrocyte ChE in mild and moderately and severely poisoned groups were respectively lowest at 12 and 24 hours after poisoning, and rose at 2 and 48 hours after poisoning. There was a significant difference (P <0.01) between 12 h after poisoning in mild poisoning group and 24 h after poisoning in moderate and severe poisoning group, ChE in erythrocytes and 6 h after poisoning, but there was no significant difference between immediately after admission Sex (P> 0.05). Plasma ChE in the three groups showed no significant difference at these three time points (P> 0.05). Four cases of death of whole blood, plasma, erythrocyte ChE immediately after admission has been significantly reduced in the course of treatment, most continue to reduce or occasionally a transient rise and then continue to decline. Conclusion: The rapid microdynamic monitoring method is feasible, trace, fast, simple, sensitive, stable, accurate and accurate. It is superior to many existing ChE detection methods. The changes of whole blood and erythrocyte ChE were positively correlated with the clinical poisoning of AOPP and the changes of their clinical conditions, which could be used as effective indicators of clinical observation. Coefficient of variation of plasma ChE, can not accurately reflect the degree of clinical poisoning and AOPP