Skold Anna, Cosco Dominique L, Klein Robin
Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA.
South Med J. 2011 Nov;104(11):757-61. doi: 10.1097/SMJ.0b013e318232139f.
The diagnosis of methemoglobinemia should be considered in patients presenting with cyanosis and hypoxia. A variety of frequently used medications are capable of inducing methemoglobinemia, with dapsone and benzocaine being common culprits. Unique features, such as a saturation gap and chocolate-brown-colored blood, can raise suspicion for methemoglobinemia. Typically, symptoms correlate with the methemoglobin level, and treatment with methylene blue is reserved for patients with significantly elevated methemoglobin levels. In the presence of comorbid conditions that impair oxygen transport, however, low-grade methemoglobinemia can become symptomatic and may warrant treatment.
对于出现紫绀和缺氧的患者，应考虑诊断高铁血红蛋白血症。多种常用药物都能诱发高铁血红蛋白血症，其中氨苯砜和苯佐卡因是常见的罪魁祸首。一些独特的特征，如饱和度差距和巧克力棕色的血液，可能会增加对高铁血红蛋白血症的怀疑。通常，症状与高铁血红蛋白水平相关，亚甲蓝治疗仅用于高铁血红蛋白水平显著升高的患者。然而，在存在损害氧运输的合并症的情况下，轻度高铁血红蛋白血症可能会出现症状，可能需要治疗。
