Research Center of Occupational Medicine, Peking University Third Hospital, Beijing, China.
Clin Hemorheol Microcirc. 2009;43(4):271-82. doi: 10.3233/CH-2009-1239.
Carbon monoxide (CO) poisoning is a leading cause of poison-related morbidity and mortality. The severe complication of delayed neuropsychiatric sequelae seriously affects patient's living quality, but its mechanism remains controversial. In this study, we established an animal model by intraperitoneal injection of CO in rabbits at regular interval and kept the carboxyhemoglobin (HbCO) level in blood above 50% for at least 24 h. We investigated the dynamic changes in the hemorheological and coagulative properties of blood taken from venae jugularis interna before CO injection and at 30 min, 1-5 days after the last CO exposure. We found that RBC count, hemoglobin (Hb) concentration, and hematocrit (Hct) increased on 1 day and remained high level till 5 day. Whole blood viscosities at different shear rates decreased significantly at 30 min and then increased 1 day later until day 4. RBC deformation index (DI) and aggregation index decreased at 30 min and recovered to normal on day 3. Plasma viscosity and fibrinogen augmented from 30 min until day 5. Prothrombin time (PT) and active partial thromboplastin time (APTT) prolonged remarkably at 30 min and went back to normal on 3 day, plasma [Ca2+] decreased at 30 min and approached to normal level on 3 day. The level of malondialdehyde (MDA) in RBCs at 30 min was significantly higher than that of control and recovered to normal on day 3. Our results suggest that the changes in hemorheology participate in the development of acute CO poisoning, which may play a role in delayed encephalopathy after acute CO poisoning.
一氧化碳(CO)中毒是导致中毒相关发病率和死亡率的主要原因之一。迟发性神经精神后遗症等严重并发症严重影响患者的生活质量,但发病机制仍存在争议。在这项研究中,我们通过每隔一段时间向兔子腹腔内注射 CO 建立了一个动物模型,使血液中的碳氧血红蛋白(HbCO)水平至少保持在 50%以上达 24 小时以上。我们研究了在 CO 注射前、最后一次 CO 暴露后 30 分钟、1-5 天从颈内静脉采集的血液的血液流变学和凝血特性的动态变化。我们发现 RBC 计数、血红蛋白(Hb)浓度和血细胞比容(Hct)在第 1 天增加,并在第 5 天保持高水平。在不同剪切率下的全血粘度在 30 分钟时显著降低,然后在 1 天后增加,直到第 4 天。RBC 变形指数(DI)和聚集指数在 30 分钟时降低,在第 3 天恢复正常。血浆粘度和纤维蛋白原从 30 分钟增加到第 5 天。凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)在 30 分钟时显著延长,在第 3 天恢复正常,血浆 [Ca2+]在 30 分钟时降低,在第 3 天接近正常水平。30 分钟时 RBC 中的丙二醛(MDA)水平明显高于对照组,在第 3 天恢复正常。我们的研究结果表明,血液流变学的变化参与了急性 CO 中毒的发展,这可能在急性 CO 中毒后的迟发性脑病中发挥作用。