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目的探讨急性有机磷农药中毒(AOPP)患者血清胆碱酯酶(Ch E)水平的变化及其与患者预后的相关性。方法选取2013年1月至2016年12月在本院救治的180例AOPP患者,根据中毒的程度分为轻度、中度和重度中毒组,并选取年龄匹配的健康体检者作为对照组;在AOPP患者入院后立即采静脉血3 ml检测Ch E、淀粉酶(AMS)、空腹血糖(FBS)和肌酸激酶同工酶(CK-MB),采用中毒指数和APACHE-II评分对患者病情的严重程度进行评价;Pearson相关分析用于评估Ch E与各指标的相关性;Logistic回归模型用于分析影响患者预后的因素。结果中毒组AMS、FBS和CK-MB水平显著高于对照组(P<0.05),Ch E水平显著低于对照组(P<0.05)。随着AOPP患者中毒程度的加剧,AMS、FBS和CK-MB水平呈现递升,而Ch E水平呈现递减(P<0.05)。相关分析结果显示,Ch E与AMS、FBS和CK-MB水平呈现负相关,并且是影响患者预后的危险因素(P<0.05)。结论检测AOPP患者的Ch E水平对于判断患者的中毒程度及预后具有指导意义。
Objective To investigate the changes of serum cholinesterase (ChE) level in patients with acute organophosphorus pesticide poisoning (AOPP) and its relationship with the prognosis of patients. Methods 180 patients with AOPP who were treated in our hospital from January 2013 to December 2016 were divided into mild, moderate and severe poisoning groups according to the degree of poisoning, and age-matched healthy subjects were selected as the control group. AOPP patients were admitted immediately after venous blood 3 ml detection of ChE, amylase (AMS), fasting blood glucose (FBS) and creatine kinase isoenzyme (CK-MB), using the poisoning index and APACHE-II score on the patient’s condition Severity; Pearson correlation analysis was used to assess the correlation between Ch E and each index; Logistic regression model was used to analyze the factors affecting the prognosis of patients. Results The levels of AMS, FBS and CK-MB in the poisoning group were significantly higher than those in the control group (P <0.05), while the levels of Ch E in the poisoning group were significantly lower than those in the control group (P <0.05). With the aggravation of poisoning in AOPP patients, the level of AMS, FBS and CK-MB increased gradually, while the level of ChE decreased (P <0.05). Correlation analysis showed that Ch E was negatively correlated with AMS, FBS and CK-MB levels and was a risk factor for prognosis (P <0.05). Conclusion Detecting ChE levels in patients with AOPP is instructive in judging the degree of poisoning and prognosis of patients.