Kinetic Study on the Recovery of Plasma Cholinesterase and Erythrocyte Acethylcholinesterase Activities after Organophosphorus Poisoning in Humans.

概要

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Kinetic analysis was used to study the time course of plasma cholinesterase (ChE) and erythrocyte acethylcholinesterase (RBC AChE) activities in 17 patients after intentional/accidental ingestion of organophosphorus pesticides. There was almost no plasma ChE until abrupt increases occurred from the 0 to 12th day after the ingestion. This initial null phase continued for more than 7 days only in cases seriously poisoned with fenitrothion, but it lasted less than 3 days even in life-threatening intoxication with other compounds. For RBC AChE, the null phase in the patients was from 3 to 6 days longer than it was for plasma ChE. The recovery of both enzymes increased exponentially and approached asymptotes, to which a simple one-compartment model was successfully fitted. The half-life for this recovery period, the mean of which was 11.3 days for plasma ChE and 26.7 days for RBC AChE, was related neither to the severity of clinical symptomes nor to the chemical structure of the pesticides. The data obtained were not sufficient to determine with more complicated models the supplementary effects of reactivation and aging on the phosphorylated enzymes. These results indicate that (1) newly formed enzyme/erythrocyte is a leading factor in the recovery, (2) the half-life of recovery is not a good indicator of the clinical course, and (3) dynamics of enzyme inhibition are different among compounds.
一般社団法人日本救急医学会の論文