Szponar Jarosław, Majewska Magdalena, Drelich Grzegorz, Kostek Halina, Tchórz Michał, Górska Agnieszka
Samodzielny Publiczny Szpital Wojewódzki im. Jana Bozego w Lublinie, Regionalny Ośrodek Toksykologii Klinicznej.
Przegl Lek. 2011;68(8):527-9.
The carbon monoxide poisoning still remains a main cause of fatal poisoning. The carbon monoxide poisoning occurs after inhalation of carbon monoxide. Carbon monoxide binds strongly to molecules, such as cytochrome oxidase, myoglobin, hemoglobin, causing hypoxia of tissues and organs. Carbon monoxide converts hemoglobin to carboxyhemoglobin and makes transport of oxygen through the body impossible and causes severe hypoxia. The only treatment is administering 100% oxygen or providing hyperbaric oxygen therapy. The central nervous system and heart are the most sensitive to hypoxia. We present the cases of two young people with no history of chronic diseases (a 24-year-old man and a 39-year-old woman) who were diagnosed NSTEMI in the course of severe carbon monoxide poisoning. Both poisoning cases were severe, both patients were unconscious when they were admitted to our hospital. We observed elevation of serum troponin level and changes in ECG (e.g. atrial fibrillation) significant for myocardial infarction.
一氧化碳中毒仍然是致命中毒的主要原因。一氧化碳中毒发生在吸入一氧化碳之后。一氧化碳与细胞色素氧化酶、肌红蛋白、血红蛋白等分子紧密结合，导致组织和器官缺氧。一氧化碳将血红蛋白转化为碳氧血红蛋白，使氧气无法在体内运输，从而导致严重缺氧。唯一的治疗方法是给予100%的氧气或提供高压氧治疗。中枢神经系统和心脏对缺氧最为敏感。我们报告了两例无慢性疾病史的年轻人（一名24岁男性和一名39岁女性）在重度一氧化碳中毒过程中被诊断为非ST段抬高型心肌梗死的病例。两例中毒情况均很严重，两名患者入院时均昏迷。我们观察到血清肌钙蛋白水平升高以及心电图出现对心肌梗死有意义的变化（如房颤）。
