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目的探讨急性一氧化碳(CO)中毒家兔红细胞微观血流变学变化及其在急性CO中毒迟发性脑病(DEACMP)发病中的作用。方法通过腹腔注射CO方法制备急性CO中毒模型,使血中HbCO浓度达到50%以上持续30~36 h。动态检测初次染毒后6 h及末次染毒后30 min、24 h、3 d、5 d、7 d、14 d时颈静脉血红细胞变形性、红细胞渗透脆性、红细胞膜流动性、红细胞电泳率、红细胞脂质过氧化产物丙二醛(MDA)等指标的变化并进行分析。结果与正常对照组相比,家兔末次染毒后30 min红细胞变形性、红细胞渗透脆性、膜流动性显著下降,逐渐恢复后,于第3天再次降低,持续约14 d;末次染毒后30 min,红细胞电泳率增快,而后逐渐恢复正常,但3 d后其值逐渐减慢,持续约14 d;红细胞脂质过氧化产物MDA含量于末次染毒后30 min明显升高,而后虽然出现下降趋势,但中毒3 d后再次升高,14 d时仍高于正常。结论急性CO中毒早期和后期均出现了红细胞变形性、膜流动性、渗透脆性、电泳率等流变学指标的异常变化;红细胞微观血流变学的此种异常变化不仅加速了急性CO中毒早期脑组织缺血缺氧性病变的发生,而且很有可能在急性CO中毒迟发性脑病的发病中发挥至关重要的作用;而红细胞脂质过氧化损伤则可能是造成红细胞上述流变学异常变化的病因学基础。
Objective To investigate the changes of erythrocyte micro-hemorheology in rabbits with acute carbon monoxide poisoning (CO) and its role in the pathogenesis of acute CO poisoning delayed encephalopathy (DEACMP). Methods Acute CO poisoning model was prepared by intraperitoneal injection of CO. HbCO concentration in blood reached 50% for 30 ~ 36 h. Dynamic changes of jugular vein erythrocyte deformability, erythrocyte osmotic fragility, erythrocyte membrane fluidity, erythrocyte electrophoresis rate were detected dynamically at 6 h after initial exposure and at 30 min, 24 h, 3 d, 5 d, 7 d and 14 d after the last exposure , Erythrocyte lipid peroxidation product malondialdehyde (MDA) and other indicators of change and analysis. Results Compared with the normal control group, the erythrocyte deformability, erythrocyte osmotic fragility and membrane fluidity decreased significantly 30 min after the last injection of the rabbits. After being gradually recovered, they were reduced again on the third day for about 14 days. After the last exposure After 30 min, the rate of erythrocyte electrophoresis increased, and then returned to normal gradually. However, after 3 days, the value of erythrocyte gradually decreased and lasted for about 14 days. MDA content of erythrocyte lipid peroxidation product increased significantly 30 min after the last exposure A downward trend, but increased again after 3 days of poisoning, still higher than normal on the 14th day. Conclusions The abnormal changes of rheology such as erythrocyte deformability, membrane fluidity, osmotic fragility and electrophoresis rate appear in both early and late stages of acute CO poisoning. Such abnormal changes of erythrocyte microscopic hemorheology not only accelerate the early phase of acute CO poisoning Hypoxic-ischemic brain damage, and most likely in the pathogenesis of acute CO poisoning delayed encephalopathy play a crucial role; and erythrocyte lipid peroxidation damage may be caused by the above red blood cells rheology abnormalities The etiology of change.