CAJ | 학술논문

目的观察并比较不同程度急性有机氟吸入中毒患者在不同时间血、尿氟质量浓度的动态变化,探讨血、尿氟质量浓度测定在急性有机氟吸入中毒诊治中的临床应用价值.方法分析2000年12月至2008年12月间浙江衢化医院收住的23例急性有机氟吸入中毒患者的临床资料,根据职业性急性有机氟中毒诊断标准(GBZ66-2002)分为轻度、中度和重度中毒组,采用离子选择性电极法动态检测中毒后1,2,3,4,5 d的血、尿氟质量浓度,同时测定同期在氟化工公司工作的10例健康员工血、尿氟离子质量浓度作为对照组,分析比较不同组和不同时间点的血、尿氟质量浓度变化.多组均数间的差异性比较采用重复测量方差分析,以P＜0.05为差异具有统计学意义.结果与轻度中毒组同时间点比较,中度中毒组血、尿氟离子质量浓度在第1～5天差异均无统计学意义(P＞0.05),而重度中毒组血、尿氟离子质量浓度在第1～5天差异均具统计学意义(P＜0.05或P＜0.01).与中度中毒组同时间点比较,重度中毒组血、尿氟离子质量浓度在第1～5天差异也均有统计学意义(P＜0.005).各中毒组血氟离子质量浓度在第1～5天均较对照组有统计学意义的升高(P＜0.05),而尿氟离子质量浓度仅在轻度中毒组第1天、中度中毒组第1～3天和重度中毒组第1～5天有统计学意义的升高(P＜0.05).结论急性有机氟吸入中毒后的5 d内,血氟离子质量浓度测定可作为诊断和判定严重程度的指标,尿氟离子质量浓度可作为中毒的诊断指标,但仅在中毒早期或重度中毒有意义.
목적 관찰병비교불동정도급성유궤불흡입중독환자재불동시간혈、뇨불질량농도적동태변화,탐토혈、뇨불질량농도측정재급성유궤불흡입중독진치중적림상응용개치.방법 분석2000년12월지2008년12월간절강구화의원수주적23례급성유궤불흡입중독환자적림상자료,근거직업성급성유궤불중독진단표준(GBZ66-2002)분위경도、중도화중도중독조,채용리자선택성전겁법동태검측중독후1,2,3,4,5 d적혈、뇨불질량농도,동시측정동기재불화공공사공작적10례건강원공혈、뇨불리자질량농도작위대조조,분석비교불동조화불동시간점적혈、뇨불질량농도변화.다조균수간적차이성비교채용중복측량방차분석,이P＜0.05위차이구유통계학의의.결과 여경도중독조동시간점비교,중도중독조혈、뇨불리자질량농도재제1～5천차이균무통계학의의(P＞0.05),이중도중독조혈、뇨불리자질량농도재제1～5천차이균구통계학의의(P＜0.05혹P＜0.01).여중도중독조동시간점비교,중도중독조혈、뇨불리자질량농도재제1～5천차이야균유통계학의의(P＜0.005).각중독조혈불리자질량농도재제1～5천균교대조조유통계학의의적승고(P＜0.05),이뇨불리자질량농도부재경도중독조제1천、중도중독조제1～3천화중도중독조제1～5천유통계학의의적승고(P＜0.05).결론 급성유궤불흡입중독후적5 d내,혈불리자질량농도측정가작위진단화판정엄중정도적지표,뇨불리자질량농도가작위중독적진단지표,단부재중독조기혹중도중독유의의.
Objective To investigate the changes of serum and urine fluorion organic fluoride poisoning by inhaling, and to probe into the clinical application value of concentrations in different degrees and at different time in patients with acute evaluating the sertm and urine fluorion concentration in acute organic fluoride poisoning by inhaling. Method A study was carried out in 23 patients, who suffered from acute organic fluoride poisoning by inhaling and were admitted Zhejiang Quhua Hospital, from December 2000 to December 2008. According to the occupational acute organic fluoride poisoning diagnostic criteria(GBZ66-2002),23 patients were divided into mild poisoning group,moderate poisoning group and severe poisoning group. Serum and urine fluorion concentration of patients at 1,2,3,4,5 d after poisoning were measured by using Ion-Selective Electrodes. Fluorion concentration of 10 staffs of Fluorine chemical company was also measured at the same period as the control group. The values of serum and urine fluorion concentration were analyzed. Differences in serum and urine fluorion concentration between groups at different time points were compared by repeated measures ANOVA and variability were deemed as statistical significance when P ＜ 0.05. Results Compared with mild poisoning group, there was no statistically significant difference ( P ＞ 0.05) in serum and urine fluorion concentration at the same time point in 1 to 5 days after poisoning in moderate poisoning group, but there was statistically significant differences ( P ＜ 0.05 or P ＜0.01) in severe poisoning group. Compared with moderate poisoning group, there was statistically significant difference ( P ＜ 0.05) in serum and urine fluorion concentration at the same time point in 1 to 5 days after poisoning in severe poisoning group. Serum fluorion concentration in 1 to 5 days after poisoning in each poisoning groupswere statistically higher than those in control group ( P ＜ 0.05), but there was statistically significant elevation ( P＜ 0.05) in urine fluorion concentration only in 1 day in mild poisoning group, in 1 to 3 days in moderate poisoning groups, in 1 to 5 days in severe poisoning group. Conclusions Serum fluorion concentration can be used as the severity index of diagnosis and determine the extent in 5 days after acute organic fluoride poisoning by inhaling,and urine fluorion concentration can also be used as diagnostic indicators of intoxication, but only in earlier stage or severe poisoning.