职业性接触一氧化碳对工人呼吸功能的影响

目的 初步探讨职业性接触一氧化碳（ＣＯ）对工人呼吸功能的影响。方法 选取某化肥厂造气车间男性非吸烟工人３５名为接触组，另选年龄与接触组接近的某机修厂６９名无粉尘和有害气体接触史的男性非吸烟工人为对照组，进行班前、班后肺功能测试。结果 接触组神经系统非特异症状出现率较高；测试班前和班后１秒时间肺活量、峰值流速、５０％肺活量时的最大呼气流速，接触组均显著低于对照组（Ｐ〈０．０５或０．０１），而接触组自     

Unstable angina and exposure to carbon monoxide.

Inhalation of small amounts of carbon monoxide diminishes the pain threshold in patients with stable angina pectoris. The aim of this study was to identify and describe patients who had been exposed unknowingly to toxic inhalations of this gas and subsequently presented to hospital with a clinical picture of unstable angina. Blood carboxyhaemoglobin levels of 104 patients referred with unstable angina to a coronary care unit were determined on admission. The likely source of carbon monoxide was identified in all patients. Three patients had definite carbon monoxide intoxication. Another five patients had evidence of minor exposure. When the three cases with carbon monoxide poisoning were excluded, the mean carboxyhaemoglobin level was 2.5% (+/- 1.3) for smokers (n = 30) and 0.6% (+/- 0.5) for non-smokers (n = 71). Use of fossil fuel combustion in an enclosed environment was responsible for the three most serious intoxications and one of the minor cases. We suggest that a number of patients admitted for coronary care with unstable angina may have significant carbon monoxide poisoning. This intoxication is often overlooked by attending physicians with the result that high concentration oxygen therapy is not administered, when it is in fact a necessary part of treatment.     

Human exposure to carbon monoxide and inhalable particulate in Beijing, China

Twenty nonsmoking volunteers were selected from the staff members of the Institute of Health according to their housing conditions. Carbon monoxide (CO) and particulate matter in the outdoor and indoor air and personal exposure were monitored simultaneously for 1 week in summer and 1 week in winter. At the same time some public areas, such as workplaces and shopping and traffic areas, were also monitored. The average outdoor concentration for CO was 1.5 ppm in summer and 3.9 ppm in winter; indoors it averaged 2.8 ppm in summer and 20.1 ppm in winter. Personal exposure fluctuated between these values. The level of COHb averaged 0.2% in summer and 1.9% in winter. The level of inhalable particles was higher in winter than in summer, but the difference was not as marked as that for CO. The activity diary showed that the time spent at home was around 66% and that total indoor (home and workplace) time was over 90%. This indicates the importance of studying indoor pollution and personal exposure.     

急性一氧化碳中毒迟发性脑病37例临床分析

急性一氧化碳中毒是急诊科和神经科在北方冬春季节常见的急症，致死、致残率高，部分昏迷患者经治疗意识恢复后2周～3个月的假愈期内可出现一氧化碳中毒迟发性脑病（DEACMP）。本文收集了1998～2006年我院及北华大学附属医院等四家医院295例急性一氧化碳中毒患者（其中DEACMP患者37例）的临床资料，对其进行回顾性分析，现报告如下。     

急性一氧化碳中毒的心脏损害临床分析

急性一氧化碳中毒对心脏的损害是存在的,通过心电图和心肌酶谱的变化可以确诊,在治疗一氧化碳中枢系统损害的同时,还应积极主动防治一氧化碳中毒所致的心脏损害.     

急性一氧化碳中毒312例临床分析

目的探讨急性一氧化碳中毒患者的发病特点、临床表现及不同治疗方法的疗效。方法回顾性分析1998年1月至2005年4月我院收治的312例急性一氧化碳中毒患者的中毒原因、发病年龄、性别、职业特点及临床表现、不同治疗方法的疗效。结果急性一氧化碳中毒居室煤烟吸入占中毒原因的首位为84·6%(264/312),职业性中毒占2·9%(9/312);职业分布农民工占76·6%(239/312);87·1%(272/312)的中毒事件发生在冬春季节。头痛、头晕、恶心、乏力、意识障碍为主要症状;碳氧血红蛋白检测阳性率为52·9%;心肌酶谱和心电图异常率分别为52·2%和20·5%。昏迷≥4h组脑水肿、肺水肿发生率分别为51·3%和15·8%,显著高于<4h组(20·9%,P<0·01;4·84%,P<0·05)。血磁联合治疗组治愈率为91·7%,显著高于常规治疗组(40%,P<0·01)和高压氧治疗组(66·7%,P<0·05)。结论一氧化碳接触史对急性一氧化碳中毒诊断具重要提示价值;意识障碍则是分级的主要依据;其严重并发症与昏迷时间密切相关;血磁联合治疗可提高其治愈率,并降低迟发脑病的发生率。     

急性一氧化碳中毒156例临床分析

目的：分析急性一氧化碳中毒患者的发病特征,探讨急性一氧化碳中毒的防治策略。方法：对156例急性一氧化碳中毒病例进行回顾性分析。结果：156例急性一氧化碳中毒患者中,女性多于男性,男女之比为1∶1.64;平均年龄21.75岁,高发年龄段是18-27岁,占78.84%;燃气热水器使用不当是急性一氧化碳中毒的主要原因占91.67%;中毒事件的高发季节为冬春季节占94.23%;临床表现主要为头晕、头痛、意识障碍等神经系统症状;以高压氧为主的综合治疗措施可取得满意疗效,总有效率达94.23%,治愈率为87.82%,中毒6h内高压氧治疗（A组）与中毒6h后高压氧治疗（B组）相比可提高治愈率（P〈0.05）。结论：深圳地区急性一氧化碳中毒的发病具有明显的性别、年龄、中毒源、季节特征,需引起重视,广泛开展针对性宣传教育和采取有效防范措施是遏制急性一氧化碳中毒的重要手段,一旦中毒应尽早行高压氧为主的综合性治疗。     

急性一氧化碳中毒89例临床治疗分析

目的探讨急性一氧化碳中毒的发生原因、人群、治疗方法及效果。方法对本院2007年11月～2011年1月收治的89例急性一氧化碳中毒患者的临床症状、实验室检查、治疗措施、疗效评价及转归进行回顾性分析。结果高压氧是治疗急性一氧化碳中毒最有效的手段,积极采取高压氧治疗及对症综合处理可明显提高疗效。结论对于急性一氧化碳中毒,高压氧早期及时介入,作为首选治疗措施,辅以其他对症综合治疗,不仅可以尽快缓解患者头昏头痛等临床症状及促进意识恢复,同时足够疗程的高压氧治疗,可以延缓或降低迟发性脑病发生。     

Reduced tar, nicotine, and carbon monoxide exposure while smoking ultralow- but not low-yield cigarettes

An unresolved public health issue is whether some modern cigarettes are less hazardous than others and whether patients who cannot stop smoking should be advised to switch to lower-yield cigarettes. We studied "tar" (estimated by urine mutagenicity), nicotine, and carbon monoxide exposure in habitual smokers switched from their usual brand to high- (15 mg of tar), low- (5 mg of tar), or ultralow-yield (1 mg of tar) cigarettes. There were no differences in exposure comparing high- or low-yield cigarettes, but tar and nicotine exposures were reduced by 49% and 56%, respectively, and carbon monoxide exposure by 36% while smoking ultralow-yield cigarettes. Similarly, in 248 subjects smoking their self-selected brand, nicotine intake, estimated by blood concentrations of its metabolite cotinine, was 40% lower in those who smoked ultralow but no different in those smoking higher yields of cigarettes. Our data indicate that ultralow-yield cigarettes do deliver substantial doses of tar, nicotine, and carbon monoxide, but that exposures are considerably less than for other cigarettes.     

25例CO中毒性脑病的临床与影像学分析

目的分析CO中毒性脑病的临床及影像学表现特征。方法回顾性分析我院2016年1月~2017年6月临床确诊的25例CO中毒性脑病的临床及影像学资料。所有患者均有2次及以上CT和(或)MRI检查资料。结果CO中毒性脑病临床表现主要包括头痛、智能及认知功能障碍、精神症状、锥体外系功能障碍、肢体功能障碍、昏迷等。本组CT及MRI表现:单纯基底节受累(n=12),单纯脑皮层受累(n=1),基底节和脑白质同时受累(n=4),基底节区及脑皮层同时受累(n=5),基底节区、脑皮层和脑白质同时受累(n=3)。伴发病变:伴急性大面积出血性脑梗死1例,伴急性中耳乳突炎8例。本组MRI在显示病变范围及损伤程度方面较CT更为直观准确,影像学随访还较好地评价病变治疗后变化及转归。结论 CO中毒性脑病表现为以急性痴呆为特征的一系列神经精神症状及体征,其影像学尤其是MRI表现具有一定特征性,CT及MRI在该病的诊断、鉴别诊断及预后评价中具有重要价值。     

一氧化碳、甲苯、正壬烷间断暴露对小鼠全血乙酰胆碱酯酶活性的影响

目的:探讨不同浓度一氧化碳、甲苯、正壬烷间断暴露对小鼠全血乙酰胆碱酯酶(AChE)活性的影响。方法:以20日龄雄性Wistar小鼠为实验对象,随机分组,每组12只。将每组小鼠暴露于预先设定好的一定浓度某种气体的密闭动物实验舱中(用色谱分析法检测舱室中气体浓度,保持浓度恒定)。暴露时间为每天4 h,持续暴露10 d。一氧化碳设置2个浓度,即57.25、114.50 mg/m3;甲苯设置3个浓度,即94、188、376 mg/m3;正壬烷设置3个浓度,即131、262、524 mg/m3。对照组气体为空气。第10天暴露完成后,将小鼠处死,取全血测AChE活性。AChE活性的测定采用硫代乙酰胆碱-硫代双硝基苯甲酸比色测定法[1]。结果:(1)不同浓度一氧化碳作用对小鼠全血AChE活性的影响:57.25 mg/m3组和114.50 mg/m3组与对照组相比差异均有统计学意义(P<0.01)。(2)不同浓度甲苯对小鼠全血AChE的影响:94 mg/m3组AChE活性低于对照组,但差异无统计学意义;188 mg/m3组和376 mg/m3组与对照组相比差异有统计学意义(P<0.01)。(3)不同浓度正壬烷对小鼠全血AChE活性的影响:3个浓度组AChE活性与对照组相比差异均无统计学意义。结论:一氧化碳、甲苯可降低小鼠全血AChE活性,对神经系统有一定的抑制作用,并显示有剂量效应关系趋势;本实验浓度的正壬烷对小鼠全血AChE活性影响不明显。     

厨房操作间一氧化碳的调查研究

目的探讨厨房操作间一氧化碳(CO)的污染水平同时找出更好的控制污染的方法,为制定厨房操作间空气卫生质量标准提供依据。方法在太原市随机选取了29户不同类型的餐饮业,对其厨房操作间空气中的CO污染指标在开工前60 min,与开工后90 min分别进行现场采样,采用方差分析的方法进行检验。结果 CO的含量在开工前后有很大的差异,开工后,其含量远远高于开工前(P<0.01),开工前,在不同类型的餐饮业中,其差别不是很显著。结论建议在制定厨房操作间CO标准时,CO 1 h平均值20 mg/m3,最高容许浓度<30 mg/m3。     

Slow recovery from carbon monoxide poisoning

A case of accidental carbon monoxide poisoning due to the incomplete combustion of natural gas is reported. The patient had prolonged coma and decerebrate rigidity, but eventual recovery of neurological and intellectual function was almost complete.