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目的:探讨急性有机磷农药中毒患者(AOPP)血清心肌酶谱变化与中毒程度的关系。方法:测定120例AOPP患者第1、3、7、11天血清谷草转氨酶(AST)、谷丙转氨酶(ALT)、磷酸肌酸激酶(CK)、磷酸肌酸激酶同功酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(-αHBDH)及胆碱酯酶(CHE)含量的变化,同时选择40例正常人作对照。结果:AOPP患者血清心肌酶与对照组比较均有不同程度升高,且中毒程度越重,CHE活性越低,心肌酶升高越明显(P<0.05或0.01)。在中、重度AOPP均出现ST-T异常、心律失常和心力衰竭;在部分重度AOPP还出现了呼吸衰竭(发生率21.1%)。结论:AOPP中毒程度越重,血清心肌酶增加越明显,心脏和肺脏损伤的发生率就越高。
Objective: To investigate the relationship between the change of serum myocardial enzymes and the degree of poisoning in patients with acute organophosphorus pesticide poisoning (AOPP). Methods: Serum AST, ALT, CK, CK-MB were measured on 120th, , Lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (-HBDH) and cholinesterase (CHE) were detected by enzyme-linked immunosorbent assay (ELISA) Results: Compared with the control group, the levels of serum myocardial enzymes in AOPP patients increased to some extent, and the more severe the poisoning was, the lower the activity of CHE was, the more significant the myocardial enzymes were increased (P <0.05 or 0.01). ST-T abnormalities, arrhythmias, and heart failure occurred in both moderate and severe AOPP; respiratory failure (21.1%) occurred in some patients with severe AOPP. Conclusion: The more serious the poisoning of AOPP, the more obvious increase of serum myocardial enzymes and the higher incidence of heart and lung injury.