库存血胆碱酯酶水平变化在重症有机磷农药中毒抢救中应用选择

目的 观察库存血保存天数与血浆胆碱酯酶（ＣＨＥ）水平变化关系,探讨急性重症有机磷农药中毒（ＡＯＰＰ）抢救中合理选择,用于换血疗法或者输血的血源。方法 输血前随机留取保留不同天数的库血测定血浆ＣＨＥ值;血液中心采血当日留取正常人血浆、即日测定ＣＨＥ值作对照组。ＣＨＥ测定用ＢＭ公司的胆碱酯酶试剂盒,Ｒｏｃｈ公司的Ｃｏｂａｓ－ＦａｒａⅡ自动分析仪测定。结果 库存血保存天数为第一天的血浆ＣＨＥ值与正常对

Alteration of banked blood cholinesterase level and its significance in emergency treatment of acute organophosphorus pesticide poisoning

OBJECTIVE: To observe the relationship between the preservation days of banked blood and the alteration level of plasma cholinesterase with the aim of making proper selection of banked blood in emergency treatment of acute organophosphorus pesticide poisoning (AOPP). METHODS: We selected at random the banked blood that has been stored for different length of time before blood transfusion so as to determine the plasma cholinesterase value. The normal plasma cholinesterase value was determined on blood samples in the Blood Center which served as a control group. The cholinesterase value was determined with a kit of the BM Company and the Cobes-Fara II automatic analysor of the Roch Company. RESULTS: It was found that there was no significant difference of plasma cholinesterase value between the one-day banked blood and the normal control group (P > 0.05), but the plasma cholinesterase values of the other experiment groups were all significantly lower than that of the control group (P < 0.05). As compared with the normal control group, the relative ratio with fixed base was about from 80 percent to 16 percent. It seems that the preservation days are in negative correlation with the cholinesterase value (r = -0.7929, P < 0.01). The curvilinear regression equation is Y = -1,823.3 Ln(X) +/- 6,229.4. CONCLUSION: With the increase of the banked blood preservation days after blood sampling, the plasma cholinesterase value decreased gradually. So in the emergency treatment of severe AOPP, it is essential to use the fresh blood collected within one day, so as to avoid missing the chance of first-aid treatment. This study provides the experimental basis for emphasizing transfusion of fresh blood and ensuring transfusion of highly active cholinesterase in treating AOPP.