急性有机磷中毒心肌酶谱的观察

目的探讨急性有机磷中毒(AOPP)患者心肌酶谱动态变化及其临床意义.方法对26例AOPP患者(中度中毒组22例,重度中毒组4例)入院当日及此后第2天、第5天、第7天、第9天和第11天重复抽空腹静脉血测定血清肌酸激酶(CK)及其同工酶(CK-MB)、谷草转氨酶(GOT)、乳酸脱氢酶(LDH)和α-羟丁酸脱氢酶(HBDB)水平.结果中度组酶值仅部分升高,重度组则明显升高,第1日值两组比较P<0.05;酶水平呈规律性变化,CK值于第2日达到高峰(与第1日比P<0.05),CK-MB、GOT、LDH及HBDB值于第1至2第日达到高峰,中度组第5至第7日降至正常,(第5日与第1日比P<0.05),重度组第7至第11日降至正常(CK、CK-MB、GOT值第5日与第1日比P<0.05,第9日与第5日比P<0.05,LDH、HBDB值第9日与第1日比P<0.05).结论中毒越重,血清CK、CK-MB、GOT、LDH及HBDB等酶值越高,酶值可用于估计AOPP病情的严重程度,并且酶值呈动态变化,病情越重酶值恢复越慢.

Changes of serum enzymes in patients with acute organphosphorus pesticide poisoning

Objective:To investigate serum enzymes changes of patients with acute organophosphorus pesticide poisoning(AOPP), and discuss its clinical significance.Methods:Serum creatine kinase(CK), creatine kinase isoenzyme MB(CK MB), glutamic oxalo acetic transaminase(GOT), lactic dehydrogenase(LDH) and a hydroxybutyric acid dehydrogenase(HBDH) in 26 patients with AOPP including middle degree poisoning group(n=22),serious poisoning group(n=4) were measured while admitted to hospital and 2nd?5th?7th?9th?11th.Results:Serum enzymes of middle group were only partially higher and of serious group significantly highter than those of the middle group(the first day,P<0.05). Serum enzymes changed regularly. CK reached its peak on 2nd(to 1st,P<0.05),CK MB?GOT?LDH?HBDH on 1st or 2nd,serum enzymes of middle group resumed on 5th to 7th(5th to 1st,P<0.05),those of serious group resumed on 7th to 11th(CK?CK MB?GOT 5th to 1st,P<0.05,9th to 5th,P<0.05,LDH?HBDH 9th to 1st,P<0.05 ).Conclusion:This study showed that the more severe the AOPP was the more significantly the enzymes increased,reflecting more severe damage in the tissue. Serum enzymes change regularly. The more severe the AOPP is, the longer it needs for the serum enzymes to resume.