Bao Hang-Xing, Tong Pei-Jian, Li Cai-Xia, Du Jing, Chen Bing-Yu, Huang Zhi-Hui, Wang Ying
First Clinical Medical College of Zhejiang Chinese Medical University Zhejiang Provincial Hospital of TCM Department of Laboratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College Department of Transfusion, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou Institute of Neuroscience and Institute of Hypoxia Medicine, Wenzhou Medical University, Wenzhou Department of Transfusion, Lishui People's Hospital, Lishui, Zhejiang, China.
Medicine (Baltimore). 2017 Mar;96(11):e6375. doi: 10.1097/MD.0000000000006375.
The mortality rate caused by organophosphate (OP) poisoning is still high, even the standard treatment such as atropine and oxime improves a lot. To search for alternative therapies, this study was aimed to investigate the effects of packed red blood cell (RBC) transfusion in acute OP poisoning, and compare the therapeutic effects of RBCs at different storage times.Patients diagnosed with OP poisoning were included in this prospective study. Fresh RBCs (packed RBCs stored less than 10 days) and longer-storage RBCs (stored more than 10 days but less than 35 days) were randomly transfused or not into OP poisoning patients. Cholinesterase (ChE) levels in blood, atropine usage and durations, pralidoxime durations were measured.We found that both fresh and longer-storage RBCs (200-400 mL) significantly increased blood ChE levels 6 hours after transfusion, shortened the duration for ChE recovery and length of hospital stay, and reduced the usage of atropine and pralidoxime. In addition, fresh RBCs demonstrated stronger therapeutic effects than longer-storage RBCs.Packed RBCs might be an alternative approach in patients with OP poisoning, especially during early stages.
有机磷（OP）中毒导致的死亡率仍然很高，即使是阿托品和肟等标准治疗方法也有了很大改进。为了寻找替代疗法，本研究旨在探讨输注浓缩红细胞（RBC）对急性OP中毒的影响，并比较不同储存时间的RBC的治疗效果。被诊断为OP中毒的患者被纳入这项前瞻性研究。将新鲜RBC（储存时间少于10天的浓缩RBC）和储存时间较长的RBC（储存时间超过10天但少于35天）随机输注或不输注给OP中毒患者。测量血液中的胆碱酯酶（ChE）水平、阿托品使用情况和持续时间、解磷定持续时间。我们发现，新鲜RBC和储存时间较长的RBC（200 - 400毫升）在输血后6小时均显著提高了血液ChE水平，缩短了ChE恢复时间和住院时间，并减少了阿托品和解磷定的使用量。此外，新鲜RBC的治疗效果比储存时间较长的RBC更强。浓缩RBC可能是OP中毒患者的一种替代治疗方法，尤其是在早期阶段。
