高压氧对急性一氧化碳中毒患者血浆一氧化氮、内皮素-1含量的影响

The effect of hyperbaric oxygenation therapy on the concentration of the nitric oxide and endothelin-1 in the plasma of patients with acute carbon monoxide poisoning

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 The purpose of this study was to evaluate the nitric oxide (NO) and Endothelin-1 (ET-1) concentration in the plasma of patients with acute carbon monoxide (CO) poisoning and the effect of hyperbaric oxygenation (HBO) therapy. Methods 66 patients were divided into 3 groups according to the different scores which was assessed with Glascow scale before HBO therapy: severe group(scale 3~7,n=17), moderate group(scale 8~10,n=21) and mild group(scale 11~15,n=28).The plasma concentration of NO and ET-1 were measured respectively by Griess methods and radioimmunoassay (RIA),and a group of heathy volunteers were also examined for control.Results Significant differences of plasma NO and ET-1 level were found between the patients and the control group and between the patients with varied Glasgow scores before the HBO therapy. The plasma level of the NO and ET-1 markedly changed after one time of HBO therapy, but still had significant differences from to the control group;while after 10 times of HBO therapy, no significant differences of plasma NO and ET-1 levels were observed between the patients and the control group.Conclusions The plasma NO and ET-1 levels changed apparantly before and after HBO therapy, therefore the concentration of plasma NO and ET-1 could be used as an index for the assessment of disease severity and therapeautic effect of HBO treatment. The HBO therapy may regulate the activity of NO and ET-1 , and may be an effective therapy for acute CO poisoning.