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目的 观测急性一氧化碳 (CO)中毒患者血浆一氧化氮 (NO)、内皮素 - 1(ET- 1)含量的变化及高压氧 (HBO)的影响。方法 6 6例 CO中毒的患者被分为轻、中、重度三组 ,分别用硝酸还原酶法、放免分析法测定治疗前后三组患者及对照组的 NO、ET- 1含量的变化。结果 HBO治疗前不同中毒程度组患者的血浆 ET- 1的含量较对照组明显升高 ,而 NO的含量则显著降低 (P<0 .0 1) ,同时各组间差异均有显著性 ;HBO治疗前后比较发现 ,HBO治疗 1次后 NO、ET- 1较治疗前有明显变化 ,但仍明显高于对照组 ;而 10次 HBO治疗后接近对照值。结论 急性 CO中毒患者血浆 ET- 1的升高及 NO的降低参与 CO造成的意识障碍的发生过程 ;这两个指标的变化可用于判断 CO中毒意识障碍程度及 HBO的疗效 ;HBO治疗对 NO、ET- 1含量的变化有有益的调节作用 ,可改善 CO的病理损害作用。
Objective To observe the changes of plasma nitric oxide (NO), endothelin - 1 (ET - 1) and hyperbaric oxygen (HBO) in patients with acute carbon monoxide poisoning. Methods Sixty-six patients with CO poisoning were divided into mild, moderate and severe groups. Nitric acid reductase and radioimmunoassay were used to determine the changes of NO and ET-1 levels in three groups before and after treatment. Results The levels of plasma ET-1 in patients with different degrees of poisoning before HBO treatment were significantly higher than those in the control group, while the contents of NO were significantly decreased (P <0.01), while the differences among the groups were significant. HBO Compared before and after treatment, NO and ET-1 in HBO treatment significantly changed compared with that before treatment, but it was still significantly higher than that in control group. The HBO treatment ten times and approached the control value. Conclusions The increase of ET-1 and the decrease of NO in patients with acute CO poisoning are involved in the process of disturbance of consciousness caused by CO. The changes of these two indexes can be used to judge the degree of disturbance of CO poisoning and the effect of HBO. ET-1 content changes have a beneficial regulatory role, can improve the role of CO pathological damage.