農薬中毒の病態生理

第4報有機燐剤慢性中毒の臨床

抄録

A study was performed on twenty-two cases diagnosed as chronic intoxication of Alkylphosphates, living in the rural sections of Aomori prefecture.The results obtaind can be summarized as follows:
(I) Many clinial examination were done to find out some characteristic findings ofchronic intoxication of Alkylphosphates. In order to do this investigation, further, other elements were researched, such as the past history, kind of work (scattering or mixing) kind of pesticides, using different methods, any complaint and exact symptome.From those analyses, several characteristic findings were found as follows:
1-The difference between men and women was not found.
2-Age was from 30 to 65 years old.
3-The period of the use of organophosphoric agricultural chemicals was from 10 to 15 years.
4-68.1% of them were farmers scattering by personal operation, not by co-operation. Only one of them wasa specialist of mixing pesticides.
5-50%of them had no complaint, 18%of them felt fatigue or had angina pectoris-like symptome.4.5% of them diziness and other symptomes.
6-68.1%of them had low serum ChE rate underΔph0.60, and 90.9%of them low serum ChE rate underΔph0.68, but no one had the nomal ChE level.
7-20%of them had pathological level of liver function tests, such as TTT and ZTT, together with a low serum ChE rate.
8-All of them showed a normal serum protein level.
9-From plasma protein fraction results, 77.2%of them had a high A/G rate, and 81.8%of them a clear low al-globulin rate. The latter is a very important finding for the diagnosis of this disease:
10-The majority of them had a lower rate of blood total Glutathione than the healthy persons.
11-Red cell sedimenttations rate, serum cholesterol, BSP test were within normal limits, electrocardiogram also.
12-Treatment of five chronic Parathion poisoning cases with Glutathione (300mg a day, for 4 weeks, oral Kudo's method) was very effective from the view points of serum ChE activity.
(II) From the investigation of frequency of this disease 3.1%of 190 farmers, using organo-phosphoric agricultural chemicals had some characteristic findings or symptomes even if they had not any complaint.
(III) In order to find out such intoxication cases clinically, it is very necessary to research many elements as shown above, like the exact and systematic Kudo's group examination method which follows:
1-We filled in cards many elements and informations about the farmers work or use of pesticides.
2-First of all, we draw about 5 ml of blood of the farmers and we measured the serum ChE rate as by screening, also we performed many clinical examinations.
3-Also we determined the cell ChE rate and the total blood ChE rate by special method (DTNB method).
4-We investigated carefully each case one by one whether these cases fit to the important and necessary conditions or elements.
5-After this examination, we investigated again about the past history, kinds of work, period of using agricultural chemicals and kinds of pesticides exactly.
6-So, by this exact and careful examination, we were able to find out in some cases a chronic intoxication of Alkylphosphates.