接触沙林毒气患者瞳孔大小与乙酰胆碱酯酶活性之间的关系。

Relationship between pupil size and acetylcholinesterase activity in patients exposed to sarin vapor.

作者信息

Nozaki H, Hori S, Shinozawa Y, Fujishima S, Takuma K, Kimura H, Suzuki M, Aikawa N

机构信息

Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Intensive Care Med. 1997 Sep;23(9):1005-7. doi: 10.1007/s001340050447.

DOI:10.1007/s001340050447

PMID:9347376

Abstract

OBJECTIVE

To elucidate the effect of sarin vapor on pupil size and erythrocyte acetylcholinesterase activity (AchE).

DESIGN

Retrospective observational survey.

SETTING

Emergency department of an urban teaching hospital.

PATIENTS

80 patients who were exposed to sarin in a terrorist attack in Tokyo subways.

MEASUREMENTS AND RESULTS

Pupil size and AchE activity on the day of exposure were measured. Among the 80 patients, the pupils were miotic (< 3 mm) in 50 patients (62.5%), while AchE activity was below the normal range (< 1.2 U) in 34 patients (42.5%). AchE was significantly lower in the miotic group than in the group with normal pupils (1.0 +/- 0.5 U vs 1.5 +/- 0.3 U, p < 0.01). In the miotic group, AchE activity was lower than normal in 32 patients (64.0%) but was decreased in only 2 patients in the normal pupil group (6.7%) (p < 0.01).

CONCLUSIONS

Miosis is a more sensitive index of exposure to sarin vapor than erythrocyte AchE. Systemic poisoning is apparently less likely to develop if the patient's pupil size is normal on arrival at the hospital.

摘要

目的

阐明沙林毒气对瞳孔大小和红细胞乙酰胆碱酯酶活性（AchE）的影响。

设计

回顾性观察调查。

地点

城市教学医院急诊科。

患者

80名在东京地铁恐怖袭击中接触沙林毒气的患者。

测量与结果

测量接触当天的瞳孔大小和AchE活性。80名患者中，50名患者（62.5%）瞳孔缩小（<3mm），而34名患者（42.5%）的AchE活性低于正常范围（<1.2U）。瞳孔缩小组的AchE显著低于瞳孔正常组（1.0±0.5U对1.5±0.3U，p<0.01）。在瞳孔缩小组中，32名患者（64.0%）的AchE活性低于正常水平，但在瞳孔正常组中只有2名患者（6.7%）的AchE活性降低（p<0.01）。