Namba T
Bull World Health Organ. 1971;44(1-3):289-307.
The clinical manifestations of acute poisoning by organophosphorus compounds in man are in accord with, initially, the stimulation and, later, the blocking of cholinergic transmission due to acetylcholinesterase inhibition. The manifestations involve mainly the para-sympathetic nerves, the neuromuscular junctions, and the central nerve synapses, and to a smaller degree the cholinergic sympathetic nerves. Miosis and muscle fasciculations are useful signs for diagnosis and for the control of therapy. Blood cholinesterase determination is the best diagnostic test. The cause of death is usually respiratory paralysis. Persistent manifestations have not been confirmed. Atropine and pralidoxime are effective for treatment and useful for diagnosis. Other oximes are promising but their clinical value has not been established. Poisoning by malathion is characterized by a prolonged course and by motor signs. Poisoning by organophosphorus compounds in man differs from animal experiments in several ways: in man, exposure may occur by several different routes, the manifestations are detected more easily, and therapy is given throughout the course of illness.
有机磷化合物急性中毒在人体的临床表现，起初符合乙酰胆碱酯酶抑制所致的胆碱能传递刺激，随后则符合胆碱能传递阻滞。这些表现主要累及副交感神经、神经肌肉接头和中枢神经突触，程度较轻地累及胆碱能交感神经。瞳孔缩小和肌肉束颤是诊断及治疗控制的有用体征。血液胆碱酯酶测定是最佳诊断试验。死亡原因通常是呼吸麻痹。持续性表现尚未得到证实。阿托品和氯解磷定对治疗有效且有助于诊断。其他肟类有前景，但它们的临床价值尚未确立。马拉硫磷中毒的特点是病程延长和出现运动体征。人体有机磷化合物中毒在几个方面与动物实验不同：在人体，接触可能通过几种不同途径发生，表现更容易被察觉，且在疾病全过程中都给予治疗。
