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目的：探讨在急性有机磷农药中毒（ＡＯＰＰ）７２小时后继续使用解磷定（ＰＡＭ）和解磷注射液对胆碱酯酶（ＣｈＥ）活性及疗效的影响。方法：８３例中、重度ＡＯＰＰ患者随机分为对照组（４３例）和治疗组（４０例），均在传统综合抢救基础上应用ＣｈＥ复能剂。对照组采用ＰＡＭ静滴，连用３日，解磷注射液即刻肌注；治疗组ＰＡＭ和解磷注射液均连用５日～７日；并用酶法测定ＣｈＥ活性。结果：治疗组和对照组治愈率分别为９７．５％和８１．４％（Ｐ＜０．０５）；治疗组治疗１周内ＣｈＥ活性〔（４０４２．２５±１４０８．５１）Ｕ／Ｌ〕及完全恢复正常时间〔（７．５６±２．１９）日〕均显著优于对照组〔分别为（２６７５．６１±１４７２．５５）Ｕ／Ｌ和（１０．４６±３．９９）日〕，Ｐ＜０．００１和Ｐ＜０．０１；治疗组和对照组１周内ＣｈＥ活性恢复正常率为８２．５％和３６．１％（Ｐ＜０．００１），并发症总发生率分别为７．５％和３４．９％（Ｐ＜０．０１）；治疗组阿托品总平均用量较对照组减少３２３．４ｍｇ（Ｐ＜０．０１），住院时间较对照组缩短３．５７日（Ｐ＜０．００１）。结论：酶活性的恢复与酶老化学说不符，老化酶仍存在被复活的可能；ＣｈＥ复能剂的应用不宜限制时?
Objective: To investigate the effect of continuous use of Phosphorus - fixing (PAM) and Phosphate - Soluble Phosphate Injection on the activity and efficacy of ChE after 72 hours of acute organophosphorus pesticide poisoning (AOPP). Methods: 83 cases of moderate and severe AOPP patients were randomly divided into control group (43 cases) and treatment group (40 cases). ChE was given on the basis of traditional comprehensive rescue. The control group received intravenous infusion of PAM, once daily for 3 days, phosphate solution immediately intramuscular injection; treatment group PAM and phosphate solution were used for 5 days to 7 days; and enzymatic activity was measured ChE. Results: The cure rates of the treatment group and the control group were 97.5% and 81.4%, respectively (P <0.05). ChE activity (4042.25 ± 1408.51) U / L in the treatment group within 1 week (7.56 ± 2.19) days] were significantly better than that of the control group [(2675.61 ± 1472.55) U / L and (10.46 ± 3.99) days, respectively] , P <0.001 and P <0.01 respectively. The normal rate of recovery of ChE activity in treatment group and control group within one week was 82.5% and 36.1% (P <0.001) respectively. The total incidence of complications were (P <0.01). The average dosage of atropine in treatment group decreased by 323.4 mg (P <0.01) and the hospitalization time was shorter than that in control group by 3.57 days (P < P <0.001). Conclusion: The recovery of enzyme activity is not consistent with the theory of enzyme aging, and the possibility of the resurrection enzyme still exists. The application of ChE agent should not be limited.