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[对硫磷中毒的脑部变化:42例观察]

[Brain changes in parathion poisoning: observations in 42 cases].

作者信息

Oehmichen M, Schlote W, Mallach H J

出版信息

Z Rechtsmed. 1983;90(3):173-89. doi: 10.1007/BF02116228.

Abstract

A total of 42 cases were examined neuropathologically to determine possible toxic changes occurring in the brain after parathion intoxication. Sporadic anoxic alterations were observed in 7% of 41 cases in which the cause of death was acute intoxication. Nearly all cases (93%), however, showed marked hyperemia, often coupled with small reactionsless, periventricular hemorrhages which occurred in 40% of the cases. In one third of the cases (33%) there was moderate swelling of the oligodendroglia. Whereas histological evidence of edema was found in nearly one third of the cases (30%), comparison of the brain weights in these subjects with those of a large comparative collective showed definite pathologic brain weights in only five cases (12%) with 95% confidence limits. It is true that in 18 cases (42%) the brain weight was above the normal value if the confidence limit is ignored. Pronounced anoxic alterations were observed in only one case in which the individual survived the acute intoxication for 4 weeks after initial respiratory arrest. Predominantly toxic changes, however, could not be detected in any of the cases examined. This negative morphologic finding does not agree with the physiologic alterations reported by other investigators using animal models; they considered the cause of death in cases of parathion intoxication to be the result of toxic paralysis of the respiratory center. The literature was discussed.

摘要

对42例病例进行了神经病理学检查,以确定对硫磷中毒后大脑中可能出现的毒性变化。在41例因急性中毒死亡的病例中,7%观察到散在的缺氧性改变。然而,几乎所有病例(93%)都表现出明显的充血,常伴有轻微的、无反应性的脑室周围出血,40%的病例出现这种情况。三分之一的病例(33%)有少突胶质细胞中度肿胀。虽然近三分之一的病例(30%)发现有水肿的组织学证据,但将这些受试者的脑重量与大量对照群体的脑重量进行比较,在仅5例(12%)病例中显示出明确的病理性脑重量,置信区间为95%。确实,如果忽略置信区间,18例(42%)的脑重量高于正常值。仅在1例病例中观察到明显的缺氧性改变,该个体在急性中毒初始呼吸骤停后存活了4周。然而,在所检查的任何病例中均未检测到主要的毒性变化。这一阴性形态学发现与其他使用动物模型的研究者报告的生理改变不一致;他们认为对硫磷中毒病例的死亡原因是呼吸中枢的毒性麻痹。对相关文献进行了讨论。

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