Singh S, Sharma N
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Neurol India. 2000 Dec;48(4):308-13.
Organophosphorous compounds, the anticholinesterases, produce significant morbidity and mortality in India. Although exact estimates are not available, hospital based statistics suggest that nearly half of the admissions to emergency with acute poisoning are due to organophosphates. Following accidental or suicidal exposure, these anticholinesterases lead to three well defined neurological syndromes i.e. initial life threatening acute cholinergic crisis which often requires management in intensive care unit, intermediate syndrome in which cranial nerve palsies, proximal muscle weakness and respiratory muscle weakness are common and patients often require respiratory support and delayed organophosphate induced polyneuropathy. In addition to these three classical neurological syndromes following acute exposure and in some following low dose chronic exposure, several neurobehavioural changes have been observed and these have been termed together as 'chronic organophosphate induced neuropsychiatric disorders' (COPIND). Organo-phosphate compounds produce significant pesticide related illness in developing countries. There is, thus, a need to determine exact extent of the problem and to develop appropriate strategies to manage these cases with available resources in these countries.
有机磷化合物，即抗胆碱酯酶，在印度造成了严重的发病和死亡情况。尽管尚无确切估计数据，但基于医院的统计表明，因急性中毒而入住急诊的患者中，近一半是由有机磷酸酯类所致。在意外或自杀性接触这些抗胆碱酯酶后，会引发三种明确的神经综合征，即最初危及生命的急性胆碱能危象，这通常需要在重症监护病房进行治疗；中间综合征，其中常见颅神经麻痹、近端肌肉无力和呼吸肌无力，患者常需呼吸支持；以及迟发性有机磷中毒性多发性神经病。除了急性接触后出现这三种典型神经综合征外，在一些低剂量慢性接触后也观察到了几种神经行为变化，这些变化被统称为“慢性有机磷中毒所致神经精神障碍”（COPIND）。有机磷化合物在发展中国家引发了严重的农药相关疾病。因此，有必要确定该问题的准确程度，并制定适当策略，以便在这些国家利用现有资源来处理这些病例。
