急性有机磷农药中毒患者肝功能及血脂变化的临床观察

目的：探讨有机磷农药中毒患者肝功能、血脂变化与中毒程度的关系。方法：急性有机磷农药中毒患者54例，轻、中、重度毒各18例，中毒24h内抽取静脉血，采用7600日立全自动化分析仪检测并比较轻、中、重度中毒患者血清中碱性磷酸酯酶（AKP）、谷氨酰转移酶（GGT）、白蛋白（ALB）、总胆固醇（TC）、甘油三酯（TG）、前白蛋白（PAB）、总胆红素（TBIL）、谷丙转氨酶（ALT）、谷草转氨酶（AST）的水平。结果：随着中毒程度加重血清TBIL、ALT、AST明显升高（P〈0．01），PAB、TC、TG明显降低（P〈0．01），重度中毒组变化最明显，组间比较差异具有统计学意义（P〈0．01）；ALB、AKP、GGT随中毒程度变化不明显，组间比较差异无统计学意义（P〉0．05）。结论：血清肝功能及血脂指标的变化有助于判断有机磷农药中毒程度，评估患者预后，对早期有效护肝治疗意义重大。

Changes of serum hepatic function in patients with acute organophophorus pesticide poisoning

Objective: To study therelationship of hepatic function,lipid and the degree of poisoning in patients with organophosphorus pesticide poisoning.Methods: Patients were divided into three groups according to the severity of intoxication:the mild,moderate and severe groups(n=18).Blood samples were taken for the measurement of serum hepatic function within 24 hours after intoxication,including alkaline phosphatase(AKP),aminoacyltransferase(GGT),albumin(ALB),total cholesterol(TC),triglyceride(TG),prealbumin(PAB),total bilirubin(TBIL),glutamate-pyruvate transaminase(GPT)and aspartate aminotransferase(AST).Results: The severer the intoxication was,the more obviously the level of ALT,AST and TBIL increased(P<0.01),the more obviously the level of TC,TG and PAB decreased(P<0.01).The severe group changed the most obviously.The difference between groups was significantly(P<0.01).ALB,AKP and GGT changed inobviously in three groups(P≧0.05).Conclusions: Hepatic function and lipid were helpful to judge the degree of poisoning,prognosis of patients and early protection of hepatic function.