Delgado Edgar, McConnell Rob, Miranda Jamilette, Keifer Matthew, Lundberg Ingvar, Partanen Timo, Wesseling Catharina
Department of Preventive Medicine, Occupational Health Program, National Autonomous University of Nicaragua at León (UNAN-León), León, Nicaragua.
Scand J Work Environ Health. 2004 Oct;30(5):362-70. doi: 10.5271/sjweh.824.
Patients hospitalized for acute organophosphate poisoning in León, Nicaragua, were followed for effects on the central nervous system (CNS) over a 2-year period.
Immediate verbal memory (Rey verbal learning), visuomotor performance (digit symbol), and neuropsychiatric symptoms (Q-16) were assessed for 53 poisoned persons at the time of hospital discharge, 7 weeks postpoisoning, and 2 years postpoisoning, and, at the same time intervals, for 28 persons who had never been poisoned. The poisonings were classified as moderate occupational (31), severe occupational (15), and severe through the oral route (7), representing low, medium, and high exposure, respectively. Longitudinal confounder-adjusted between-category comparisons and longitudinal analyses of variance and covariance were used to assess the effects of the exposure.
Immediate verbal learning showed deficits in the high-exposure group, in particular at the time of discharge, but the estimate of the difference when compared with the values of the unexposed was imprecise. Visuomotor performance showed a deficit at 7 weeks in the medium-exposure group, but it had improved after 2 years relative to that of the unexposed, for whom improvement had occurred at 7 weeks and persisted during the 2 years of follow-up, possibly a test-retest effect. Neuropsychiatric symptoms were in excess 2 years after the hospital discharge in the low- and medium-exposure groups and all the groups combined. All the results were imprecise for the small high-exposure group.
Visuomotor performance and possibly short-term verbal memory seem to be affected early after severe acute organophosphate poisoning and recover, either truly or by some compensatory mechanism. Neuropsychiatric symptoms seem to increase after a longer latency period.
对尼加拉瓜莱昂因急性有机磷中毒住院的患者进行为期2年的随访，观察其对中枢神经系统（CNS）的影响。
对53名中毒患者在出院时、中毒后7周和中毒后2年进行即时言语记忆（雷氏言语学习）、视运动表现（数字符号）和神经精神症状（Q-16）评估，同时对28名从未中毒的人在相同时间间隔进行评估。中毒情况分为中度职业中毒（31例）、重度职业中毒（15例）和经口重度中毒（7例），分别代表低、中、高暴露水平。采用纵向混杂因素调整后的组间比较以及纵向方差分析和协方差分析来评估暴露的影响。
即时言语学习在高暴露组存在缺陷，尤其是在出院时，但与未暴露组的值相比，差异估计不精确。视运动表现在中度暴露组中毒后7周存在缺陷，但2年后相对于未暴露组有所改善，未暴露组在7周时有所改善且在2年随访期间持续改善，这可能是重测效应。低暴露组和中度暴露组以及所有组合并后，出院2年后神经精神症状均有增加。对于小的高暴露组，所有结果均不精确。
严重急性有机磷中毒后，视运动表现以及可能的短期言语记忆似乎早期受到影响并恢复，可能是真正恢复或通过某种代偿机制恢复。神经精神症状似乎在较长潜伏期后增加。
