【摘要】 目的　探讨内皮素 (ET)与急性有机磷农药中毒 (AOPP)后多器官功能障碍综合征 (MODS)的关系及临床价值。方法　应用放射免疫法检测 38例AOPP后MODS患者与 30名健康人血浆ET水平 ,分析AOPP后MODS患者血浆ET水平与APACHEⅡ、全血胆碱酯酶 (AChE)活力、心肌肌钙蛋白I (cTnI)、血清酶学、血生化等指标的关系。结果　AOPP后MODS患者血浆内皮素水平较正常对照组明显升高 (P <0 0 1) ,死亡组与非死亡组血浆ET水平明显高于正常对照组 (P <0 0 1) ,而死亡组血浆ET明显高于非死亡组 (P <0 0 1)。血浆ET与与APACHEⅡ评分、 (cTnI)、肌酸激酶同工酶 (CK -MB)、乳酸脱氢酶 (LDH)、丙氨酸氨基转移酶 (ALT)、天门冬氨酸氨基转移酶 (AST)、血尿素氮 (BUN)、血肌酐 (Scr)呈正相关 (P<0 0 1或 0 0 5 ) ,与AChE呈显著负相关 (P <0 0 1)。结论　ET参与了AOPP后MODS的发病过程 ,且与APACHEⅡ评分呈正相关关系 ,血浆ET可作为AOPP后MODS患者多器官功能损害程度的评估、指导治疗、观察病情变化与预后判断的临床指标之一 ,使用ET拮抗剂或抑制剂对防治MODS的发生发展有重要的临床意义。更多还原

【Abstract】 Objective To investigate the relationship between endothelin (ET)and multiple organ dysfunction syndrome (MODS) caused by acute organophosphorus pesticide poisoning (AOPP). Methods The levels of plasma ET were measured by radioimmunoassay in 38 patients with MODS caused by AOPP and 30 healthy persons,The level of plasma ET patients in MODS caused by AOPP with APACHEⅡscore,all blood cholinesterase(AChE) activity,cardiac troponin I(cTnI),blood enzymology and biochemistry indexes were analysed.Results The level of plasma ET in patients with MODS caused by AOPP was much higher than controls(P<0.01),the levels of plasma ET in death group and non-death group was much higher than that of controls groups (P<0.01),the levels of plasma ET in death group was much higher than that of non-death group. Plasma ET was positively correlated with APACHEⅡscore, AChE activity, cTnI,creatine kinase-MB(CK-MB),lactate dehydrogenase(LDH), alanine aminotransferase(ALT), aspartate aminotransferase(AST), blood urea nitrogen(BUN) and serum creatinine(Scr)(P<0.05 or 0.01),there was a negative correlation with AchE activity (P<0.05).Conclusion Endothelin may be involved in the pathogenesis of MODS caused by AOPP,there was positively correlated with APACHEⅡscore,plasma ET may be one of a clinical index of evaluate in multiple organ function damage degree, guide therapeutic,examining the patients’ condition and judging their prognosis of MODS caused by AOPP.更多还原