摘要
目的：研究高压氧（ＨＢＯ）对急性一氧化碳（ＣＯ）中毒患者血浆内皮素－１（ＥＴ－１）含量的影响，探讨ＥＴ－１与患者意识障碍的关系。方法：应用放免分析法测定２６名急性ＣＯ中毒患者（分为轻、中、重３组）ＨＢＯ治疗前后血浆ＥＴ－１水平；另设正常对照组３０人，测定ＥＴ－１对照值。结果：ＨＢＯ治疗前不同等级的中毒组血浆ＥＴ－１含量明显不同，为重度＞中度＞轻度＞对照组，同时各组相互间均有非常显著差异（Ｐ＜０．０１）；ＨＢＯ治疗前后比较发现，ＨＢＯ治疗１次后ＥＴ－１含量明显降低（Ｐ＜０．０１），１０次后接近对照值（Ｐ＞０．０５）。结论：（１）急性ＣＯ中毒患者血浆ＥＴ－１水平可明显升高，经ＨＢＯ治疗后则显著降低，故测定ＥＴ－１浓度变化可用于判定ＣＯ中毒的病情及ＨＢＯ疗效。（２）ＥＴ－１浓度与急性ＣＯ中毒患者的意识障碍程度呈正相关。（３）ＨＢＯ有可能成为临床多系统疾病伴有体内ＥＴ－１升高情况的一种新的有效治疗方法。
Aim: To study the effect of hyperbaric oxygen (HBO)on endothelin-1 (ET-1 ) concentra-tion in plasma of patients with acute carbon monoxide(CO)poisoning,and to probe the correlation be-tween ET-1 and consciousness of the patient.Methods:The consciousness of 26 patients with acute CO poisoning was assessed with Glasgow scale before HBO therapy. The patients were divided into 3 groups according to the different scores: severe(scale 3～7,n=10),moderate(scale 8～10,n=9)and mild(scale 11～15,n=7).The plasma concentrations of ET-1 were measured by the method of ra- dioimmunoassy (RIA),and a group of 30 healthy volunteers was also examined for control. Results: Significant differences(P< 0.01 ) of plasma ET-1 level were present between the patients with varied Glasgovv scores before the HBO therapy, and their ET-1 levels were severe(87. 48 ± 8. 56 pg/ml),moderate (69. 25±4. 14 pg/ml),mild (60. 52±7.73 pg/ml) and control(28. 33±6. 60 pg/ml) respec-tively. Significant decreases(P< 0. 01 ) of plasma ET-1 level were found after HBO therapy in all the patient groups, while no significant differences(P> 0. 05)were found between the control and those groups of patients after the 10th HBO treatment. Conclusion:(1)The plasma ET-1 levels were elevated in patients with acute CO poisoning and decreased after HBO therapy apparantly, therefore the concen-tration of plasma ET-1 could be used as an index for the assessment of disease severity and therapeautic ffect of the HBO treatment.(2)Positive correlation was found between plasma ET-1 level and the de-gree of consciousness.(3) HBO therapy may be an effective method in the treatment of different kinds of diseases accompanied by high level plasma ET-1.
