急性有机磷中毒193例临床分析

目的:探讨急性有机磷中毒(AOPP)所致呼吸衰竭(呼衰)、心力衰竭(心衰)以及重度AOPP合并血清淀粉酶升高的危险因素.方法:193例AOPP患者按毒物种类、中毒程度分组,比较各组间呼衰、心衰发生情况有无差异；分析中毒24h内血清胆碱酯酶(CHE)水平与呼衰、心衰的相关性,重度中毒患者血清淀粉酶升高的危险因素.结果:毒物种类对患者呼衰、心衰影响无统计学差异；重度中毒组呼衰、心衰发生率较轻、中度组明显升高(均P＜0.05);呼衰组和心衰组血清CHE水平均明显低于非呼衰组和非心衰组(均P＜0.05)；敌敌畏中毒和中毒24 h内血清CHE水平与血清淀粉酶水平存在一定相关性.结论:中毒程度和血清CHE水平可作为AOPP呼衰、心衰发生的预测指标；敌敌畏中毒和血清CHE水平明显降低是重度AOPP患者血清淀粉酶升高的2个危险因素.

Clinical analysis of 193 cases with acute organophosphorus pesticide poisoning

Objective: To investigate the risk factors of acute organophosphorus pesticide poisoning (AOPP) induced respiratory failure, heart failure and severe AOPP complicated with elevated serum amylase. Methods: One hundred and ninety-three patients with AOPP were divided according to the variety of poison and degree of intoxication. The differences of frequencies of respiratory failure and heart failure among each group were compared. The correlation between respiratory and heart failure and serum level of cholinesterase (CHE) within 24 hours after poisoning were analyzed. The risk factors of elevated serum amylase in severe AOPP were also analyzed. Results: The effect of variety of poison on patients′ respiratory failure, heart failure was not statistically significant; the incidence of respiratory failure and heart failure were obviously higher in severe AOPP than those in mild and moderate AOPP (P<0.05); the serum level of CHE was significantly lower in respiratory failure group and the heart failure group than that of the non-respiratory failure group and the non-heart failure group (P<0.05). There was certain relevance between the serum level of CHE and amylase within 24 hours in dichlorvos poisoning. Conclusions: The degree of severity of intoxication and serum level of CHE can be used as predictors for the occurrence of respiratory failure and heart failure; dichlorvos poisoning and lower serum level of CHE were risk factors for the elevated serum amylase in patients with AOPP.