carbon monoxide poisoning levels
When the body is in a strong a lot of stress state, the release of anterior pituitary -endorphin ( -ep) and to participate in its pathophysiology . The study by radioimmunoassay on 32 patients, moderate to severe carbon monoxide (co) poisoning patients -ep concentrations were measured and evaluated to explore its clinical significance.1. Object: co poisoning in 32 patients, 18 males and 14 females; aged 20 to 45 years, mean age 27.6 years. Were hospitalized or diagnosed by clinical observation with patients. 9 cases of moderate to light coma, and severe in 23 cases of deep coma, and part of the pulmonary edema, shock and cardiac arrhythmia, of which 1 died. Were confirmed by high-pressure oxygen, intravenous infusion of 20% mannitol, dexamethasone and cell nourishment, and so conventional treatment, without naloxone treatment. Control group, 25 patients, 13 males and 12 females, aged 18 to 42 years, mean age 28.3 years, were healthy hospital.2. Methods: poisoning group before treatment and after three and a control group 24,48 h fasting venous blood samples taken elbow collected 2 ml, quick inspection, the 3 000 r / min the serum was separated and stored at -20 under test. -ep radioimmunoassay Hartcourt tax by Beijing Institute of Biological Products RIA kit, using equilibrium saturation analysis, full-time staff from the hospital in strict accordance with the instructions required testing.3. Statistical analysis: West China University of Medical Statistics pems u
sing the software, using t test and analysis of variance test q newman-keuls Law, computer processing, with the measured value s said.Poisoning in the treatment group before and after 24 h -ep levels higher than the control group (p <0.05); 48 h after the -ep levels compared with the control group, the difference was not significant ( 0.05). After treatment, 24,48 h -ep levels lower than before treatment, compared with before treatment there was significant difference (p <0.01), Table
Table 1 co poisoning before and after with control group comparison of serum -ep levels (ng / l, s) group of -ept the number of cases the value of the control group of 25 q values
57.27 14.97 before treatment 32119.94 63.09 * 5.43 after treatment, 24 h3280.98 39.62 * 3.114.98 after treatment, 48 h3265.78 18.10 1.946.92Note: Compared with control group, * p <0.05; compared with before treatment, p <0.01Discussion of co poisoning acute inhalation of high concentrations of co mainly due to the formation of carboxyhemoglobin lose oxygen and ability to cause brain, heart, kidney and other tissues of the hypoxia. Hypoxic stress in the poisoning case of pituitary release of a large number of -ep. At present the mechanism of -ep has not been fully elucidated. The mechanism of induction are: (1) with high levels of -ep role of endogenous nerve block, causing synaptic transmission disorder, a direct inhibitory effect on the nerve center , inhibition of respiration and circulation center. (2) high levels of -ep longer able to directly reduce cerebral blood flow, and produces the brain microcirculation, increased brain tissue hypoxia. -ep by inhibiting prostaglandin and adenylate cyclase , the inhibition of prostaglandin and thromboxane prostaglandin imbalance between the balance, which has a strong vasoconstriction, the increase in blood viscosity, platelet aggregation, extensive micro-thrombosis, foreign reports to -ep into the dog''s ventricle in the visible phenomena of platelet aggregation . While high levels of -ep inhibition of adenylate cyclase, the atp conversion to reduce the camp, but also to cerebral vasoconstriction, reducing blood supply to brain tissue. The consequences of these effects can be exacerbated brain damage induced by endogenous opioid peptides secondary brain injury. The results showed that the duration of different periods of intoxication group -ep levels higher than those in the control group, but within 24 h after treatment, -ep levels decreased 48 h after treatment has been less than 24 h before treatment and the level. Help with the condition improved, -ep levels decreased slowly, last longer state of the high level of -ep. The mechanism through increased co poisoning patients hypoxic brain damage, caused by secondary brain injury. These results also opioid receptor antagonist naloxone treatment in the co poisoning and the need to provide evidence. Naloxone on lifting the nerve center of inhibition of -ep, and can block or reverse the high levels of -ep secondary brain tissue damage caused, it is recommended within 48 h in the treatment of repeated use of naloxone.