Smith R M, Neuman T S
Division of Pulmonary and Critical Care Medicine, University of California, San Diego 92126, USA.
J Emerg Med. 1997 May-Jun;15(3):285-9. doi: 10.1016/s0736-4679(97)00007-3.
Although diving-associated arterial gas emboli have been thought to embolize the cerebral circulation preferentially, more recent evidence suggests that gas bubbles disseminate widely and may cause dysfunction in multiple organ systems. We performed a retrospective survey of the records of patients presenting with diving-associated gas embolism over a 10-yr period to determine the maximal levels of serum transaminases and lactate dehydrogenase after a diving accident. Twenty-nine subjects with arterial gas embolism were identified whose dive profiles suggested that decompression sickness was unlikely. Maximal transaminase levels (aspartate amino transaminase = 442 +/- 187 IU/L; alanine amino transaminase = 315 +/- 205 IU/L) and lactate dehydrogenase level (800 +/- 227 IU/L) were significantly greater in the gas embolism patients than those levels measured in a group of normal individuals undergoing training dives of similar depth and duration. These preliminary studies suggest that arterial gas embolism frequently produces significant abnormalities in serum enzyme activity in sport divers whose dives would not be expected to produce decompression sickness. Arterialized gas bubbles may circulate widely, causing injury outside of the cerebral circulation.
尽管人们一直认为与潜水相关的动脉气体栓塞会优先栓塞脑循环，但最近的证据表明，气泡会广泛扩散，并可能导致多个器官系统功能障碍。我们对10年间出现与潜水相关气体栓塞的患者记录进行了回顾性调查，以确定潜水事故后血清转氨酶和乳酸脱氢酶的最高水平。确定了29名动脉气体栓塞患者，其潜水情况表明不太可能发生减压病。气体栓塞患者的转氨酶最高水平（天冬氨酸氨基转氨酶=442±187 IU/L；丙氨酸氨基转氨酶=315±205 IU/L）和乳酸脱氢酶水平（800±227 IU/L）显著高于一组进行类似深度和时长训练潜水的正常个体所测水平。这些初步研究表明，在预计不会发生减压病的体育潜水员中，动脉气体栓塞经常会导致血清酶活性出现显著异常。动脉化气泡可能会广泛循环，在脑循环之外造成损伤。
