Department of Pharmacology, Faculty of Medicine, University of Ruhuna, Karapitiya, Galle, Sri Lanka.
PLoS One. 2012;7(5):e37987. doi: 10.1371/journal.pone.0037987. Epub 2012 May 24.
Autonomic dysfunction after chronic low level exposure to organophosphorus (OP) pesticides has been consistently reported in the literature, but not following a single acute overdose. In order to study autonomic function after an acute OP overdose, sixty-six overdose patients were compared to 70 matched controls. Assessment of autonomic function was done by heart rate response to standing, deep breathing (HR-DB) and Valsalva manoeuvre; blood pressure (BP) response to standing and sustained hand grip; amplitude and latency of sympathetic skin response (SSR); pupil size and post-void urine volume. The patients were assessed one and six weeks after the exposure. The number of patients who showed abnormal autonomic function compared to standard cut-off values did not show statistically significantly difference from that of controls by Chi-Square test. When compared to the controls at one week the only significant differences consistent with autonomic dysfunction were change of diastolic BP 3 min after standing, HR-DB, SSR-Amplitude, SSR-Latency, post-void urine volume and size of the pupil. At 6 weeks significant recovery of autonomic function was observed and only HR-DB was decreased to a minor degree, -5 beats/min [95%CI 2-8]. This study provides good evidence for the lack of long term autonomic dysfunction following acute exposure to OP pesticides.
慢性低水平接触有机磷（OP）农药后会出现自主神经功能障碍，这在文献中有过相关报道，但单次急性过量接触不会出现这种情况。为了研究急性 OP 农药过量接触后的自主神经功能，我们将 66 名过量接触患者与 70 名匹配对照进行了比较。通过心率对直立、深呼吸（HR-DB）和瓦尔萨尔瓦动作的反应，血压对直立和持续握力的反应，交感神经皮肤反应（SSR）的幅度和潜伏期，瞳孔大小和排尿后尿量来评估自主神经功能。患者在接触后一周和六周进行评估。与标准截断值相比，显示自主神经功能异常的患者数量与对照相比，通过卡方检验没有统计学上的显著差异。与对照组相比，在一周时唯一一致提示自主神经功能障碍的显著差异是站立 3 分钟后的舒张压变化、HR-DB、SSR 幅度、SSR 潜伏期、排尿后尿量和瞳孔大小。在 6 周时观察到自主神经功能明显恢复，只有 HR-DB 略有下降，为-5 次/分钟[95%CI 2-8]。本研究为急性接触 OP 农药后长期自主神经功能障碍缺乏提供了有力证据。
