Dungdung Ajit, Kumar Abhinav, Kumar Bindey, Preetam Mukul, Tara Ruth K, Saba Md K
Department of Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
J Family Med Prim Care. 2020 Apr 30;9(4):1873-1877. doi: 10.4103/jfmpc.jfmpc_205_20. eCollection 2020 Apr.
Organophosphorus (OP) are substances that are originally produced by the reaction of alcohols and phosphoric acid. These OP compounds are the main components of herbicides, pesticides, and insecticides. These are easily available in developing country like India; there is lack of awareness about these chemicals which results in high morbidity and mortality.
To estimate levels of amylase, lipase, plasma cholinesterase in acute OP poisoning. To assess severity of OP poisoning by using plasma cholinesterase levels and correlating it with other two markers. Predicting the severity of acute OP poisoning by using these biochemical markers.
A hospital-based observational study was conducted on 100 subjects who were clinically diagnosed of acute OP poisoning. Subjects of either gender of all age-groups were included in the study. On admission, plasma cholinesterase, serum amylase, and serum lipase were measured. Based on plasma cholinesterase activity at the time of admission, subjects were divided into three groups. Group I-having 20-50% of plasma cholinesterase activity; Group II-10-20% of plasma cholinesterase activity; and Group III <10% of plasma cholinesterase activity.
Among 100 patients it was seen that serum amylase and serum lipase were negatively correlated with plasma cholinesterase levels and it was statistically significant. It was seen that serum amylase had the highest diagnostic accuracy for assessing severity of poisoning, 10 deaths were there in which 6 had <10% of plasma cholinesterase activity, 8 out of these 10 patients had elevated amylase level.
OP poisoning is associated with elevated amylase level. Serum amylase, lipase can be used as an additional prognostic indicator along with plasma cholinesterase levels. Serum amylase could be considered as a better predictor of severity than lipase.
有机磷（OP）是由醇类与磷酸反应最初生成的物质。这些有机磷化合物是除草剂、杀虫剂和农药的主要成分。在印度这样的发展中国家，它们很容易获得；人们对这些化学品缺乏认识，导致高发病率和高死亡率。
估计急性有机磷中毒时淀粉酶、脂肪酶、血浆胆碱酯酶的水平。通过血浆胆碱酯酶水平评估有机磷中毒的严重程度，并将其与其他两个指标相关联。利用这些生化指标预测急性有机磷中毒的严重程度。
对100例临床诊断为急性有机磷中毒的受试者进行了一项基于医院的观察性研究。所有年龄组的男女受试者均纳入研究。入院时，测量血浆胆碱酯酶、血清淀粉酶和血清脂肪酶。根据入院时血浆胆碱酯酶活性，将受试者分为三组。第一组血浆胆碱酯酶活性为20 - 50%；第二组血浆胆碱酯酶活性为10 - 20%；第三组血浆胆碱酯酶活性<10%。
在100例患者中，发现血清淀粉酶和血清脂肪酶与血浆胆碱酯酶水平呈负相关，且具有统计学意义。发现血清淀粉酶在评估中毒严重程度方面具有最高的诊断准确性，有10例死亡，其中6例血浆胆碱酯酶活性<10%，这10例患者中有8例淀粉酶水平升高。
有机磷中毒与淀粉酶水平升高有关。血清淀粉酶、脂肪酶可与血浆胆碱酯酶水平一起用作额外的预后指标。血清淀粉酶可被认为是比脂肪酶更好的严重程度预测指标。
