Abstract：
Acute organophosphate poisoning kills tens of thousands of people annually around the world. These substances are widely used as insecticides in homes, industry, and agricultural environments. Due to the ease of access, they can cause accidental or intentional risks of exposure through the skin or respiratory contact. This study aimed to evaluate the serum levels of hs-CRP, Vitronectin, and NT-proBNP and their relationship with the extent and severity of cardiac complications in patients with organophosphate pesticide poisoning. In this descriptive-comparative study, 160 patients were studied with acute organophosphate poisoning. Also, for better comparison, 40 healthy individuals participated in this study. Diagnosis of organophosphate poisoning was based on clinical findings of serum butyrylcholinesterase levels. The hs-CRP measurement was performed by an autoanalyzer (Abbott, model Alcyon 300, USA) with the ELISA hs-CRP kit (The apDia Company, Belgium). Vitronectin (VN) measurements were performed by ELISA method and Glory science human VN kit with Catalog No: 11668. NT-ProBNP serum levels were analyzed by ProBNP assay kit (Roche, Germany) by ECLIA method using Elecsys 2010 Analyzer. The most important variables studied in this study were the electrical activity and conduction system of the heart, PR distance, QTC interval, and T-wave changes. In this study, most of the patients were women and girls (60.78%). The highest percentage of organophosphate poisoning was in the age group of 15-24 years (37.25%). In most cases (78.43%), poisoning was intentional or suicidal. Evaluation of electrophysiological abnormalities of the heart showed that 89 patients (55.62%) had long QTC interval (>450 msec), 43 cases (26.87%) had possible long QTC (431-450 msec), and 28 cases (17.5%) had normal QTC (<430 msec). Only 9.37% of cases (n = 15) showed an increase in P-R distance, which is characteristic of the first-degree ventricular atrial block. Sinus bradycardia occurred in 57 cases (35.62%) and sinus tachycardia in 43 cases (26.87%); in 60 cases (37.5%), the pulse rate was normal. Smooth T-wave changes were observed in 9.8% of patients and reverse T-wave was observed in 17.6%. A long T-wave was not reported in any case. In only two cases (1.25%) was grade 1 ventricular atrial block and grade 2 and 3 blocks were not observed. In general, there was a significant difference in the hs-CRP, vitronectin, and NT-proBNP serum levels between the patient and control groups in all studied variables. These parameters were also related to the extent and severity of the disease.
摘要：
急性有机磷中毒每年在世界各地杀死成千上万的人。这些物质在家庭中广泛用作杀虫剂，工业,和农业环境。由于容易进入，它们可能会通过皮肤或呼吸道接触引起意外或故意暴露的风险。本研究旨在评估血清hs-CRP水平，玻连蛋白,和NT-proBNP及其与有机磷农药中毒患者心脏并发症的程度和严重程度的关系。在这项描述性比较研究中，研究了160例急性有机磷中毒患者。此外，为了更好的比较，40名健康个体参与了这项研究。有机磷中毒的诊断基于血清丁酰胆碱酯酶水平的临床表现。hs-CRP测量由自动分析仪(雅培，美国Alcyon300模型)与ELISAhs-CRP试剂盒(TheapDiaCompany，比利时)。通过ELISA方法和目录号为11668的GloryScience人VN试剂盒进行玻连蛋白(VN)测量。NT-ProBNP血清水平通过ProBNP检测试剂盒（Roche，德国)采用ECLIA方法，使用Elecsys2010分析仪。这项研究中研究的最重要的变量是心脏的电活动和传导系统，PR距离,QTC间期,和T波变化。在这项研究中,大多数患者是妇女和女孩(60.78%)。有机磷中毒的比例最高的是15-24岁年龄段（37.25％）。在大多数情况下（78.43%），中毒是故意或自杀。心脏电生理异常评估显示89例(55.62%)患者QTC间期较长(>450毫秒),43例（26.87％）可能存在长QTC（431-450毫秒），28例(17.5%)QTC正常(<430毫秒)。只有9.37%的病例（n=15）显示P-R距离增加，这是一级心室心房传导阻滞的特征。窦性心动过缓57例(35.62%),窦性心动过速43例(26.87%);60例(37.5%),脉搏率正常。在9.8％的患者中观察到平滑的T波变化，在17.6％的患者中观察到反向T波。在任何情况下均未报告长T波。仅有2例（1.25％）为1级心室房传导阻滞，未观察到2级和3级房传导阻滞。总的来说,hs-CRP有显著差异，玻连蛋白,在所有研究变量中，患者组和对照组之间的NT-proBNP血清水平。这些参数也与疾病的程度和严重程度有关。
