Thorsen E, Haave H, Hofsø D, Ulvik R J
Department of Clinical Biochemistry, University of Bergen, Haukeland University Hospital, Norway.
Undersea Hyperb Med. 2001 Summer;28(2):57-62.
A reduction in hemoglobin concentration has been consistently reported after deep saturation dives, whereas reductions in thrombocyte counts and changes in biochemical parameters specific for liver function have been reported after some dives. In this study the contribution of exposure to hyperoxia to these changes were studied. Hemoglobin concentration, blood cell counts, serum ferritin, and biochemical parameters specific for liver damage were measured before and after a shallow 28-day saturation dive to a pressure of 250 kPa with the same hyperoxic exposure (40-50 kPa) as in a deep saturation dive in eight male divers. The same parameters were measured before, during, and after a standard 21-day hyperbaric oxygen (HBO2) treatment series in a selected group of 16 patients (8 male). There were significant reductions in hemoglobin concentrations of 3.8 +/- 4.7% (P = 0.023) and 10.2 +/- 5.3% (P = 0.003) after the HBO2 treatment series and dive, respectively, accompanied with reductions in red cell counts, reticulocyte counts, and hematocrit. There was an increase in ferritin concentrations of 29 +/- 21% (P = 0.002) and 107 +/- 43% (P < 0.001). In contrast to some deep dives, there were no changes in thrombocyte counts or biochemical parameters specific for liver damage. Exposure to hyperoxia contributes significantly to reduced hemoglobin and increased ferritin concentrations after saturation dives. The changes may reflect a shift of iron from synthesis of hemoglobin in the bone marrow to storage in macrophages caused by a downregulation of hemoglobin synthesis, or an increased oxidative stress. The changes are too small to be of clinical significance with respect to diving and HBO2 treatment.
深度饱和潜水后一直有血红蛋白浓度降低的报道，而在一些潜水后也有血小板计数降低以及肝功能特异性生化参数变化的报道。在本研究中，探讨了暴露于高氧环境对这些变化的影响。在8名男性潜水员进行28天浅度饱和潜水至250 kPa压力后，测量其血红蛋白浓度、血细胞计数、血清铁蛋白以及肝损伤特异性生化参数，此次潜水的高氧暴露（40 - 50 kPa）与深度饱和潜水相同。在16名选定患者（8名男性）进行标准的21天高压氧（HBO₂）治疗前后及治疗期间，测量相同参数。HBO₂治疗系列和潜水后，血红蛋白浓度分别显著降低3.8±4.7%（P = 0.023）和10.2±5.3%（P = 0.003），同时红细胞计数、网织红细胞计数和血细胞比容降低。铁蛋白浓度分别升高29±21%（P = 0.002）和107±43%（P < 0.001）。与一些深度潜水不同，血小板计数或肝损伤特异性生化参数没有变化。暴露于高氧环境对饱和潜水后血红蛋白降低和铁蛋白浓度升高有显著影响。这些变化可能反映了由于血红蛋白合成下调，铁从骨髓中血红蛋白的合成部位转移至巨噬细胞储存，或者是氧化应激增加。就潜水和HBO₂治疗而言，这些变化太小，不具有临床意义。
