Futagami K, Tanaka N, Nishimura M, Tateishi H, Aoyama T, Oishi R
Department of Hospital Pharmacy, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Int J Clin Pharmacol Ther. 1996 Oct;34(10):453-6.
We observed 6 patients with severe fenitrothion and/or malathion poisoning necessitating artificial ventilation and intensive care monitoring. Three developed relapse following acute cholinergic crisis. In these patients the blood urea nitrogen (BUN) abnormally elevated before the development of relapse and the initial high concentration of plasma organophosphate (OP) decreased only gradually. However, the patients who did not develop relapse showed no elevation of BUN and a relatively low concentration of plasma OP. This observation was confirmed in a retrospective search of 14 patients. In addition, erythrocyte cholinesterase (EChE) activities were more helpful to diagnose the development of relapse than plasma cholinesterase activities. Therefore, careful monitoring of BUN in addition to plasma OP concentration may be useful to predict the development of relapse.
我们观察了6例因重度杀螟硫磷和/或马拉硫磷中毒而需要人工通气和重症监护监测的患者。3例在急性胆碱能危象后出现复发。在这些患者中，复发前血尿素氮（BUN）异常升高，血浆有机磷（OP）初始高浓度仅逐渐下降。然而，未复发的患者BUN未升高，血浆OP浓度相对较低。这一观察结果在对14例患者的回顾性研究中得到证实。此外，红细胞胆碱酯酶（EChE）活性比血浆胆碱酯酶活性更有助于诊断复发的发生。因此，除了监测血浆OP浓度外，仔细监测BUN可能有助于预测复发的发生。
