Valero A, Alroy G, Eisenkraft B, Itskovitch J
Thorax. 1974 Nov;29(6):703-9. doi: 10.1136/thx.29.6.703.
, , 703-709. A study of 36 patients was undertaken to evaluate the role of raised blood and CSF ammonia in the production of central nervous manifestations in chronic obstructive pulmonary disease (COPD) with special reference to congestive right ventricular failure (CRVF). The patient material comprised five categories: 11 controls, seven mentally alert patients with COPD, eight with COPD and CRVF, four with primary cardiac disease and CRVF, and eight with cirrhosis of the liver. Each patient was examined clinically especially for neurological manifestations such as asterixis, confusion, and drowsiness. Each patient also had measurement of venous pressure, bromsulphthalein, ECG, chest radiograph, and spirometry. The mean values of CSF-glutamine, CSF and arterial blood-ammonia, pH, co, and o for each group were compared and statistically analysed. The results indicate that no correlation existed between central nervous manifestations acid-base balance or o. Ammonia-glutamine levels were found to relate to hepatic congestion whether it was caused by primary cardiac or pulmonary heart disease.
（页码范围）703 - 709。对36例患者进行了一项研究，以评估血液和脑脊液氨升高在慢性阻塞性肺疾病（COPD）中枢神经表现产生中的作用，特别提及充血性右心衰竭（CRVF）。患者材料包括五类：11名对照者、7名神志清醒的COPD患者、8名患有COPD和CRVF的患者、4名患有原发性心脏病和CRVF的患者以及8名肝硬化患者。对每位患者进行临床检查，尤其检查如扑翼样震颤、意识模糊和嗜睡等神经学表现。每位患者还进行了静脉压测量、酚磺酞试验、心电图、胸部X线片和肺量测定。比较并统计分析了每组脑脊液谷氨酰胺、脑脊液和动脉血氨、pH、二氧化碳和氧的平均值。结果表明，中枢神经表现与酸碱平衡或氧之间不存在相关性。发现氨 - 谷氨酰胺水平与肝充血有关，无论肝充血是由原发性心脏病还是肺源性心脏病引起。
