Yasuda H, Yamaya M, Yanai M, Ohrui T, Sasaki H
Department of Geriatric and Respiratory Medicine, Tohoku University School of Medicine, Sendai 980-8574, Japan.
Thorax. 2002 Sep;57(9):779-83. doi: 10.1136/thorax.57.9.779.
Exhaled carbon monoxide has been reported to increase in inflammatory pulmonary diseases and to be correlated with blood carboxyhaemoglobin (Hb-CO) concentration. A study was undertaken to determine whether arterial blood Hb-CO increases in patients with inflammatory pulmonary diseases.
The Hb-CO concentration in arterial blood was measured with a spectrophotometer in 34 normal control subjects, 24 patients with bronchial asthma, 52 patients with pneumonia, and 21 patients with idiopathic pulmonary fibrosis (IPF).
The mean (SE) Hb-CO concentrations in patients with bronchial asthma during exacerbations (n=24, 1.05 (0.05)%), with pneumonia at the onset of illness (n=52, 1.08 (0.06)%), and with IPF (n=21, 1.03 (0.09)%) were significantly higher than those in control subjects (n=34, 0.60 (0.07)%) (mean difference 0.45% (95% confidence interval (CI) 0.23 to 0.67), p<0.01 in patients with bronchial asthma, mean difference 0.48% (95% CI 0.35 to 0.60), p<0.0001 in patients with pneumonia, and mean difference 0.43% (95% CI 0.26 to 0.61) p<0.001 in patients with IPF). In 20 patients with bronchial asthma the Hb-CO concentration decreased after 3 weeks of treatment with oral glucocorticoids (p<0.001). In 20 patients with pneumonia the Hb-CO concentration had decreased after 3 weeks when patients showed evidence of clinical improvement (p<0.001). The values of C-reactive protein (CRP), an acute phase protein, correlated with Hb-CO concentrations in patients with pneumonia (r=0.74, p<0.0001) and in those with IPF (r=0.46, p<0.01). In patients with bronchial asthma changes in Hb-CO concentrations were significantly correlated with those in forced expiratory volume in 1 second (FEV(1)) after 3 weeks (r=0.67, p<0.01). Exhaled carbon monoxide (CO) concentrations were correlated with Hb-CO concentrations (n=33, r=0.80, p<0.0001).
Hb-CO concentrations are increased in inflammatory pulmonary diseases including bronchial asthma, pneumonia, and IPF. Measurement of arterial Hb-CO may be a useful means of monitoring pulmonary inflammation.
据报道，呼出一氧化碳在炎症性肺部疾病中会升高，且与血液中碳氧血红蛋白（Hb-CO）浓度相关。本研究旨在确定炎症性肺部疾病患者的动脉血Hb-CO是否升高。
用分光光度计测量了34名正常对照者、24名支气管哮喘患者、52名肺炎患者和21名特发性肺纤维化（IPF）患者的动脉血Hb-CO浓度。
支气管哮喘急性加重期患者（n=24，1.05（0.05）%）、肺炎发病初期患者（n=52，1.08（0.06）%）和IPF患者（n=21，1.03（0.09）%）的平均（SE）Hb-CO浓度显著高于对照者（n=34，0.60（0.07）%）（支气管哮喘患者平均差异0.45%（95%置信区间（CI）0.23至0.67），p<0.01；肺炎患者平均差异0.48%（95%CI 0.35至0.60），p<0.0001；IPF患者平均差异0.43%（95%CI 0.26至0.61），p<0.001）。20名支气管哮喘患者经口服糖皮质激素治疗3周后，Hb-CO浓度降低（p<0.001）。20名肺炎患者在病程3周且有临床改善迹象时，Hb-CO浓度降低（p<0.001）。急性期蛋白C反应蛋白（CRP）的值与肺炎患者（r=0.74，p<0.0001）和IPF患者（r=0.46，p<0.01）的Hb-CO浓度相关。在支气管哮喘患者中，3周后Hb-CO浓度变化与一秒用力呼气量（FEV₁）变化显著相关（r=0.67，p<0.01）。呼出一氧化碳（CO）浓度与Hb-CO浓度相关（n=33，r=0.80，p<0.0001）。
在包括支气管哮喘、肺炎和IPF在内的炎症性肺部疾病中，Hb-CO浓度升高。测量动脉血Hb-CO可能是监测肺部炎症的一种有用方法。
