急性有机磷中毒治疗中的阿托品依赖现象

在急性有机磷农药中毒治疗中临床医生比较重视中毒反跳，貌似反跳的阿托品依赖现象尚未引起充分认识。作者分析了７年间收治的１０３９例中毒患者，发生依赖１５７例，占１５．１％。描述了依赖的临床表现，提出了依赖的诊断条件及其与反跳的鉴别要点，讨论了其临床意义。发现年轻者，中毒程度重、阿托品维持时间长和用量大者依赖发生率高（Ｐ均＜０．００５）。认为其机理可能与Ｍ受体数目上调和乙酰胆碱在突触间隙内蓄积过多有关。

ATROPINE DEPENDENCE DURING TREATMENT OF ACUTE ORGANOPHOSPHORUS PESTICIDES POISONING

n treating patients with acute organophosphorus pesticides poisoning,clinicians pay more atten-tion to poisoning counterattack, while atropine dependence, which resembles counterattack,is not yet fully recognized.The authors analysed 1 039 patients with this kind of poisoning treated in 7 years.Among these cases 157 were dependent on atropine, consisting of 15.1% of the total.The clinical mani-festations of the dependence were described. The diagnostic criteria of the dependence and its differential points from counterattack were suggested.It was found that higher occurrence rate of the dependence was seen in patients of younger age, with more severe poisoning and with longer duration and higher total dose of atropine treatment(P< 0. 005 respectively),It is considered that its mechanism might be related to increased number of M-receptor and excessive accumulation of acetylcholine,It is suggested that quantitative analysis of relevant receptor be developed.