在接受重症监护的患者中,急性巨芽细胞骨髓变化的发生率和发病因子
Lancet (London, England)
|October 16, 1982
概括
氧化麻醉可以导致巨细胞骨髓变化和DNA合成异常,特别是在重症患者中. 从这些影响中恢复的速度比心脏手术患者慢,更严重.
科学领域:
- 血液学 血液学 血液学
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 氧化 (N2O) 是一种常见的麻醉剂.
- 众所周知,N2O通过非活性化甲氨酸合成酶来干扰DNA合成.
- N2O对患有先前病情的重症患者的影响尚未完全理解.
研究的目的:
- 调查重症患者中巨芽细胞骨髓变化和DNA合成异常的发生率和发病原因.
- 评估氧化麻醉在这些变化中的作用.
- 为了比较N2O在重症监护室 (ICU) 患者和接受心脏旁路手术的患者的影响.
主要方法:
- 对70名入住ICU的重病患者进行前性研究.
- 通过使用脱氧氨 (dU) 抑制试验,评估巨细胞骨髓变化和DNA合成异常.
- 记录了氧化麻醉暴露的历史.
主要成果:
- 在入院时,22名患者的骨髓中存在巨质细胞变化,其中18人接受了N2O麻醉.
- 患有巨芽细胞变化 (16/18) 的患者的死亡率高于患有正常芽细胞骨髓 (7/22) 的患者.
- 在暴露于N2O的39/42名患者中发现了异常的dU抑制测试,恢复速度比心脏手术患者慢.
结论:
- 氧化麻醉是重症患者中巨芽细胞骨髓变化和DNA合成异常的重要原因.
- 与心脏手术患者相比,这些影响更严重,ICU患者的康复速度更慢.
- 在康复期间,dU抑制测试模式从暗示维生素B12缺乏转变为叶酸缺乏,表明复杂的代谢障碍.
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