Acute Organic Phosphorus poisoning (AOPP) is one of the common acute poisoning in rural areas of China. The mortality rate of severe patients is high and the diagnosis and treatment strategy is not uniform. Now on its epidemiological characteristics, poisoning mechanism, diagnosis and critique of the evaluation and treatment of the following as a review.
Epidemiological characteristics of AOPP
Organic Phosphorus pesticides are widely used throughout the world and cause acute or chronic poisoning due to occupational, accidental or intentional exposure, causing great harm to humans. In the modern chemical warfare and terrorist attacks, the Organic Phosphorus neurotransmitter is the most used, the most toxic, the most powerful chemical weapons
Device. According to WHO estimates that there are 3 million cases of organic phosphorus poisoning each year, especially in Asian countries die every year Organic Phosphorus poisoning has 250,000 cases, significantly in rural areas. After 2000, the study of Organic Phosphorus poisoning showed that the mortality was below 15%. Developing countries are much higher than in developed countries. At present, there is no definite data on the incidence of Organic Phosphorus poisoning in China. The initial statistics are located in the first single disease of acute poisoning, and the survival rate has been improved in recent years. The mortality rate of class Ⅰ Organic Phosphorus poisoning classified by WHO is 9.5%.
AOPP classical mechanism is the inhibition of enzymes, mainly cholinesterase (Chol). Organic phosphorus binds to serine hydroxyl groups at the esterification site of ChE to form a phosphorylated ChE which is difficult to hydrolyze, so that ChE cleaves acetylcholine (ACh) function loss, a large amount of ACh accumulation, causing cholinergic nerve conduction dysfunction, a series of poisoning Symptoms, mainly manifested as muscarinic-like, nicotine-like symptoms and central nervous system symptoms, resulting in serious damage to the body. In addition to the inhibition of ChE, organic phosphorus also inhibits neuropathy target esterase (NTE) acting on the central and peripheral nervous system. In recent years, studies on organophosphate poisoning have shown that Organic Phosphorus poisoning is not limited to cholinesterase Inhibition, another important mechanism is organophosphate (organophosphate) can induce oxidative damage, the body produces reactive oxygen species (reactive oxygengen species, ROS), in addition to causing direct damage to the organism, but also mediate signaling pathways, the formation of inflammatory mediators, Organ damage. The study also found that organic phosphorus solvent formulations can have a direct toxic effect on the respiratory system, and even can improve the toxicity of organic phosphorus.Therefore, the toxicity of organic phosphorus solvent can not be ignored.