Gazi University School of Medicine, Department of Emergency Medicine, Ankara, Turkey.
Am J Emerg Med. 2013 Mar;31(3):520-3. doi: 10.1016/j.ajem.2012.10.005. Epub 2012 Dec 5.
Previous studies have shown that carbon monoxide, which is endogenously produced, is increased in community-acquired pneumonia (CAP). However, it has not been studied enough whether severity of pneumonia is correlated with increased carboxyhemoglobin (COHb) concentrations in CAP. The aim of this study was to determine whether endogenous carbon monoxide levels in patients with CAP were higher compared with the control group and, if so, to determine whether COHb concentrations could predict severity in CAP.
Eighty-two patients with CAP were evaluated in this cross-sectional study during a 10-month period. Demographic data, pneumonia severity index and confusion, uremia, rate respiratory, pressure blood, age>65 (CURB-65) scores, hospital admission or discharge decisions, and 30-day hospital mortality rate were recorded. In addition, 83 control subjects were included to study. The COHb concentration was measured in arterial blood sample.
The levels of COHb in patients with CAP were 1.70% (minimum-maximum, 0.8-3.2), whereas those in control subjects, 1.40% (minimum-maximum, 0.8-2.9). The higher COHb concentrations in patients with CAP were statistically significant (P < .05). Concentration of COHb correlated with pneumonia severity index (P = .04, r = 0.187); however, it did not correlate with CURB-65 (P = .218, r = 0.112).
Although COHb concentrations show an increase in patients with pneumonia, it was concluded that this increase did not act as an indicator in diagnosis process or prediction of clinical severity for the physicians.
先前的研究表明,内源性产生的一氧化碳在社区获得性肺炎(CAP)中增加。然而,肺炎的严重程度与 CAP 中增加的碳氧血红蛋白(COHb)浓度之间的相关性尚未得到充分研究。本研究旨在确定 CAP 患者体内内源性一氧化碳水平是否高于对照组,如果是,确定 COHb 浓度是否可以预测 CAP 的严重程度。
在这项为期 10 个月的横断面研究中,评估了 82 例 CAP 患者。记录了人口统计学数据、肺炎严重指数和意识障碍、肾功能不全、呼吸急促、血压升高、年龄>65 岁(CURB-65)评分、住院或出院决策以及 30 天住院死亡率。此外,还纳入了 83 名对照者进行研究。测量了动脉血样中的 COHb 浓度。
CAP 患者的 COHb 水平为 1.70%(最低-最高,0.8-3.2),而对照组为 1.40%(最低-最高,0.8-2.9)。CAP 患者的 COHb 浓度升高具有统计学意义(P <.05)。COHb 浓度与肺炎严重指数相关(P =.04,r = 0.187);然而,它与 CURB-65 无关(P =.218,r = 0.112)。
尽管 CAP 患者的 COHb 浓度升高,但研究结论认为,这种升高不能作为医生诊断过程或预测临床严重程度的指标。