Central nervous system effects of acute organophosphate poisoning in a two-year follow-up
Central nervous system effects of acute organophosphate poisoning in a two-year follow-up
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DOI：
10.5271/sjweh.824
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发表时间：
2004-10-01
影响因子：
6.3
通讯作者：
Wesseling, C
中科院分区：
文献类型：
--
作者：
Delgado, E;McConnell, R;Wesseling, C
目的对在尼加拉瓜莱昂因急性有机磷中毒住院的患者进行为期2年的中枢神经系统（CNS）影响随访。（Rey verbal learning），visuality performance（数字符号），和神经精神症状（Q-16）进行了评估53中毒者出院时，中毒后7周，中毒后2年，在相同的时间间隔内，28人从未中毒。中毒被分为中度职业中毒（31起）、重度职业中毒（15起）和重度口服中毒（7起），分别代表低、中和高接触。纵向混淆调整类别间比较和纵向分析的方差和协方差被用来评估的影响exposed.Results立即口头学习表现出赤字的高曝光组，特别是在出院时，但估计的差异相比，未曝光的值是不精确的。中等暴露组的视力表现在7周时出现缺陷，但2年后相对于未暴露组有所改善，未暴露组在7周时出现改善，并在2年的随访期间持续改善，可能是重测效应。在低暴露组和中等暴露组以及所有暴露组中，神经精神症状在出院后超过2年。所有的结果是不精确的小高exposure group.Conclusions visualization性能和可能的短期言语记忆似乎受到严重急性有机磷中毒后的早期恢复，无论是真正的或通过某种补偿机制。神经精神症状似乎在较长的潜伏期后增加。
Objectives Patients hospitalized for acute organophosphate poisoning in Leon, Nicaragua, were followed for effects on the central nervous system (CNS) over a 2-year period.Methods Immediate verbal memory (Rey verbal learning), visuomotor performance (digit symbol), and neuropsychiatric symptoms (Q-16) were assessed for 53 poisoned persons at the time of hospital discharge, 7 weeks postpoisoning, and 2 years postpoisoning, and, at the same time intervals, for 28 persons who had never been poisoned. The poisonings were classified as moderate occupational (31), severe occupational (15), and severe through the oral route (7), representing low, medium, and high exposure, respectively. Longitudinal confounder-adjusted between-category comparisons and longitudinal analyses of variance and covariance were used to assess the effects of the exposure.Results Immediate verbal learning showed deficits in the high-exposure group, in particular at the time of discharge, but the estimate of the difference when compared with the values of the unexposed was imprecise. Visuomotor performance showed a deficit at 7 weeks in the medium-exposure group, but it had improved after 2 years relative to that of the unexposed, for whom improvement had occurred at 7 weeks and persisted during the 2 years of follow-up, possibly a test-retest effect. Neuropsychiatric symptoms were in excess 2 years after the hospital discharge in the low- and medium-exposure groups and all the groups combined. All the results were imprecise for the small high-exposure group.Conclusions Visuomotor performance and possibly short-term verbal memory seem to be affected early after severe acute organophosphate poisoning and recover, either truly or by some compensatory mechanism. Neuropsychiatric symptoms seem to increase after a longer latency period.