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頁籤選單縮合
題名 | 一氧化碳中毒對心臟功能的影響=The Impact of Carbon Monoxide Intoxication in Cardiovascular System |
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作者姓名(中文) | 謝忠岳; 黃立言; 蔡宗能; 李柏群; | 書刊名 | 內科學誌 |
卷期 | 27:5 2016.10[民105.10] |
頁次 | 頁223-232 |
分類號 | 418.85 |
關鍵詞 | 一氧化碳; 心臟衰竭; 心臟功能失調; 心律不整; 冠狀動脈疾病; 一氧化碳血紅素; 高壓氧治療; Carbon monoxide; CO; Heart failure; Heart dysfunction; Arrhythmia; Coronary artery disease; CAD; Carboxyhemoglobin; COHb; Hyperbaric oxygen therapy; HBO; |
語文 | 中文(Chinese) |
中文摘要 | 一氧化碳(Carbon Monoxide;CO)為無色、無味、無刺激性且不易被察覺的氣體,一般來自於碳氫化合物不完全燃燒所產生。在全球統計的毒物中毒致死案例中,一氧化碳中毒(Carbon Monoxide Poisoning)是最常見的類型。一氧化碳與血紅素具有高親和力與複雜的生物學特性,所以當一氧化碳中毒後,往往會造成心臟、神經、肌肉、腎臟等器官組織的病變。在心臟血管系統方面,一氧化碳中毒會造成心肌缺氧(Myocardial ischemia)、心臟功能失調(Heart dysfunction)與心律不整(Arrhythmia),並且增加冠狀動脈疾病(Coronary artery disease;CAD)症狀惡化的風險。急性一氧化碳中毒的症狀與其預後,與最初抵達醫院時所測得的一氧化碳血紅素(Carboxyhemoglobin;COHb)濃度,並無絕對相關性。而一氧化碳之致病機轉中除了造成組織的缺氧外,還與身體自由基的產生有關。在許多與一氧化碳中毒之相關研究中發現,組織中一氧化碳濃度對身體造成的影響,遠比血液中一氧化碳濃度來的重要。一氧化碳在人體的半衰期大約4-5 小時,在急性一氧化碳中毒患者,若能及時給予氧氣或高壓氧治療(Hyperbaric oxygen therapy;HBO),其半衰期可快速下降,不但可減少心血管組織缺氧,並降低心臟血管系統內自由基所造成的受損。 |
英文摘要 | Carbon Monoxide (CO) is an orderless, color less and non-irritable gas that cannot be easy detected. The major source of CO is coming from the incomplete burning of hydrocarbon compound. CO intoxication is the major cause of intoxication worldwide. Due to the high affinity of CO with Hemoglobin, the CO intoxication would cause the injury of organs such as heart, neurological system, muscle and kidney. In the cardiovascular system, CO intoxication can lead to myocardial ischemia, heart dysfunction and arrhythmia. Moreover, it will increase the deteriorated symptom of coronary artery disease. The symptom and prognosis of CO intoxication patients is not correlation to the serum level of carboxyhemoglobin that assessed at emergency room. The fruity evidence showed the concentration of CO in the tissue is more important than the blood. CO in not only caused the hypoxia of tissue, but also the production of free radical that lead to the damage of organs. In acute CO intoxication patients, the immediate treatment with oxygen or hyperbaric oxygen is important. The adequate treatment can reduce the hypoxia of tissue and decrease the damage caused by free radial. |
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