有机磷农药中毒患者肝肾功能变化的研究

目的 探讨急性有机磷农药中毒患者血清肝肾功能的变化。方法 对61例急性有机磷农药中毒患者于中毒后20h内抽取静脉血进行血清肝肾功能及胆碱脂酶（ChE）检测，并与54例治愈组和63例健康对照组进行比较。做统计学分析。结果 急性有机磷农药中毒后轻度中毒患者ChE有明显降低（P〈0．001）；中度中毒总胆红素（TBIL）、直接胆红素（DBIL）、尿素氮（BUN）、天冬氨酸转氨酶（AST）有明显升高而总蛋白（TP）、尿酸（UA）、ChE有明显降低（P均〈0．001）；重度中毒TBIL、DBIL、谷氨酸丙酮酸转氨酶（ALT）、AST、肌酐（Cr）、BUN均有升高明显而TP、UA、白蛋白（ALB）、ChE降低明显（P均〈0．001），有7例心跳停止及6例呼吸肌麻痹各项指标变化最明显者7例死亡。结论 观察血清肝肾功能的变化可以判断有机磷农药中毒患者的中毒程度及预后。

The study on changes of serum hepatic function and renal function in patients with acute organophosphorus pesticide poisoning

Objective To explore the changes of hepatic function and renal function in patients with organophosphorus pesticide poisoning.Methods Blood simples were taken for measurement of serum hepatic function,renal function and cholinesterase(ChE) of 61 cases with acute organophosphorus pesticide poisoning were examinated within 20 hours after intoxication.Moreover,to compare the change of hepatic function and renal function between recovery group(n=61) and control group(n=65)individually.Results In mild poisoning cases,ChE decreased obviously(P<0.001);in moderate poisoning cases,Serum total bilirubin(TBIL),direct bilirubin(DBIL),blood urea nitrogen(BUN) and aspartate aminotransferase(AST) levels were increased obviously,but total protein(TP),uric acid(UA) and ChE levels were decreased obviously(all P<0.001);in severe poisoning cases,TBIL,DBIL,glutamicpyruvic transaminase(ALT),AST,creatinine(Cr) and BUN levels were raised obviously,TP,UA,Albumin(ALB),ChE were decreased obviously(all P<0.001).7 of 13 cases with cardiac arrest or respiratory muscular paralysis in poisoning group had most remarkable changes of these serum indices and died.Conclusion To observe changes of serum hepatic function and renal function in patients with acute organophosphorus poisoning have a great value in judging the degree of poisoning or prognosis.