Lee D, Hsu T L, Chen C H, Wang S P, Chang M S
Department of Internal Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1996 May;57(5):355-9.
Carbon monoxide intoxication usually disturbs the normal human biochemical respiratory chain cascade from which high affinity of carboxyhemoglobin to oxygen causes ischemic insult to the human tissues and cells. Ubiquitous injuries to human cells have already been well documented for a long period of time. Here we reported a 42-year-old female who was sent to the medical emergent unit under the suspicion of carbon monoxide exposure mainly with neurologic deficits. Serum carboxyhemoglobin level was found to be 18%. Serial revolutional changes of serum CK level and ECG were noted. The echocardiogram showed hypokinesia of left ventricular apical lateral wall. Normal coronary arteriogram was found in later admission date. The patient received hyperbaric oxygen therapy and was discharged with residual psychotic symptoms. This report presented normal coronary arteriogram with serial EKG and biochemical changes in a victim of CO intoxication with evidence of myocardial infarction. Impaired oxygen delivery and disturbed intracellular mitochondrial metabolism were considered to be responsible for the ischemic insult associated with carbon monoxide exposure. The role of hyperbaric oxygen therapy was also discussed in this report; however, more experiences in application are needed to determine it's benefits for patients.
一氧化碳中毒通常会扰乱人体正常的生化呼吸链级联反应，其中碳氧血红蛋白对氧气的高亲和力会导致人体组织和细胞遭受缺血性损伤。长期以来，人体细胞普遍受到损伤这一点已有充分记录。在此，我们报告一名42岁女性，她因疑似一氧化碳中毒被送往急诊科，主要表现为神经功能缺损。发现血清碳氧血红蛋白水平为18%。注意到血清肌酸激酶水平和心电图的一系列变化。超声心动图显示左心室心尖侧壁运动减弱。在后来的入院日期冠状动脉造影正常。患者接受了高压氧治疗，出院时仍有残留的精神症状。本报告展示了一氧化碳中毒受害者冠状动脉造影正常，但伴有一系列心电图和生化变化，并存在心肌梗死证据。氧气输送受损和细胞内线粒体代谢紊乱被认为是与一氧化碳暴露相关的缺血性损伤的原因。本报告还讨论了高压氧治疗的作用；然而，需要更多的应用经验来确定其对患者的益处。
