阿维菌素与有机磷农药混配中毒的临床研究

目的探讨混合生物农药阿维菌素与有机磷农药混配后,通过不同途径对人的作用机制、中毒量及中毒程度,寻求有效解毒方法。方法对59例病例进行对照研究,探讨急性中毒患者中毒时、2、3 d血生化指标、胆碱酯酶(CHE)、血浆炎性介质C-反应蛋白(CRP)、APACHEⅡ变化等临床指标变化。血清经丙酮萃取后,用火焰光度气相色谱法直接测定混合农药含量。结果 3组间性别、年龄无统计学意义;CHE活性测定、CRP与A-PACHEⅡ评分3组间,差异有统计学意义(P<0.01)。结论有机磷农药与阿维菌素混配后,毒性呈相加作用。CHE活性测定、CRP与APACHEⅡ评分可帮助临床判断预后,为治疗提供依据。利用气相色谱分析,了解农药毒性,可作为评估混配农药中毒严重程度及预后判断提供有效指标。

Clinical study on therapy of acute poisoning of abamectin combined with organophosphorous

Objective To explore the poisoning mechanism and poisoning dose of hybrid biological pesticide abamectin mixed organophosphorus pesticide,and search for an effective detoxification method.Methods The comparison study of 59 cases with acute poisoning by hybrid biological pesticide abamectin mixed organophosphorus pesticide,and the blood biochemical index,cholinesterase,plasma inflammatory mediators C-reaction protein,APACHE Ⅱ change and other clinical indicators were determined at the poisoning,the second day after poisoning and the third day after poisoning,and blood drug concentration were determined by gas chromatography.Results The gender and age were not statistical significance among three groups.There were significant difference in CHE activity determination,C-reaction protein and APACHE Ⅱ score among three groups(p < 0.01).Conclusion The toxicity is increased by organophosphorus pesticide mixed abamectin.It can predict clinical prognosis by determination of CHE activity,C-reaction protein and APACHE Ⅱ score,and provide the basis for treatment.