目的探讨急性有机磷农药中毒(AOPP)患者血白细胞、心肌酶、肿瘤坏死因子(TNF-α)的变化及其在呼衰发生中的临床意义。方法对88例 AOPP 中毒患者,按病情分轻、中、重度组,重度组中再分无呼衰组、呼衰存活组、呼衰死亡组。以门诊健康体检者30例为正常对照组。受试者分别采血检测 WBC、N、HCT,AST、LDH、CK、CK-MB,同时采用双抗体夹心 ELISA 法测定TNF-α。结果中毒患者心肌酶、WBC 均较对照组明显升高,但在各中毒组间无显著差异;TNF-α较对照组明显升高,且中毒程度越重,升高越明显,在各组间有显著差异。重度中毒组中,死亡组较存活组 CK-MB 升高明显,呼衰组较无呼衰组 CK 增高明显;TNF-α在3组间有显著性差异,无呼衰组中最低,呼衰死亡组中最高。结论 WBC、N、特别是 TNF-α可用来判断中毒程度、估计预后。重度组中 CK、CK-MB 增高提示预后不良。TNF-α与有机磷中毒呼吸衰竭的发生有关。 Objective To investigate the changes of leukocyte, myocardial enzyme and tumor necrosis factor (TNF-α) in patients with acute organophosphorus pesticide poisoning (AOPP) and its clinical significance in the onset of respiratory failure. Methods A total of 88 patients with AOPP poisoning were divided into mild, moderate, severe and severe groups according to their condition, including no respiratory failure group, respiratory failure survival group and respiratory failure and death group. Outpatient health examination of 30 cases as a normal control group. Blood samples were collected to test WBC, N, HCT, AST, LDH, CK and CK-MB respectively. Meanwhile, TNF-α was measured by double antibody sandwich ELISA. Results The levels of myocardial enzymes and WBC in poisoned patients were significantly higher than those in control group, but there was no significant difference among the poisoning groups. TNF-α was significantly higher than that in control group, and the more severe the poisoning was, the more obvious the increase was. There are significant differences. Severe poisoning group, the death group than the survival group CK-MB increased significantly, respiratory failure group compared with non-respiratory failure group CK increased significantly; TNF-α in the three groups were significantly different, no respiratory failure group minimum, respiratory failure Highest death group. Conclusion WBC, N, especially TNF-α can be used to determine the degree of poisoning, prognosis. Severe group of CK, CK-MB increased the poor prognosis. TNF-α and organophosphate poisoning respiratory failure related.