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中枢神经系统氧中毒发生机制及防治措施
张静静1,沈越2,刘文武3,钱皎2,刘冲1*
0
(1. 海军军医大学(第二军医大学)药学系药理学教研室, 上海 200433;
2. 海军军医大学(第二军医大学)长海医院药学部, 上海 200433;
3. 海军军医大学(第二军医大学)海军特色医学中心, 上海 200433
*通信作者)
摘要:
生命活动离不开氧,但氧过多(分压过高)也会对机体造成不良影响,称为氧中毒。呼吸较高分压的氧,在短时间内会出现以惊厥为主要症状的一系列临床表现,称为中枢神经系统(或急性)氧中毒。中枢神经系统氧中毒是限制潜水作业、水下特种作战、疾病治疗等用氧的主要因素。中枢神经系统氧中毒的发生机制目前不明确,除了间歇性吸氧和严格控制用氧的压力-时程外,尚未有预防中枢神经系统氧中毒的有效手段,中枢神经系统氧中毒的发病机制和防治仍是潜水医学领域研究的重点与难点。本文对近年国内外研究报道的中枢神经系统氧中毒发生机制和防治措施进行总结,旨在为临床和科研提供参考。
关键词:  中枢神经系统疾病  氧中毒  氧化性应激  神经递质  腺苷  一氧化氮
DOI:10.16781/j.0258-879x.2021.04.0426
投稿时间:2020-12-09修订日期:2021-01-04
基金项目:国家自然科学基金(81772015).
Pathogenesis and prevention of central nervous system oxygen toxicity
ZHANG Jing-jing1,SHEN Yue2,LIU Wen-wu3,QIAN Jiao2,LIU Chong1*
(1. Department of Pharmacology, School of Pharmacy, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Pharmacy, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
3. Naval Special Medical Center, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Oxygen is fundamental to life activities, but excessive oxygen (too high partial pressure) is harmful for the body, which is known as oxygen toxicity. Oxygen with high partial pressure can cause a series of clinical manifestations with convulsion as the main symptom in a short time, which is called central nervous system (or acute) oxygen toxicity. Central nervous system oxygen toxicity is the main restriction for the use of oxygen in diving operations, underwater special operations, and disease treatment. The pathogenesis of central nervous system oxygen toxicity is not clear yet. There are few effective ways to prevent central nervous system oxygen toxicity except intermittent oxygen inhalation and strict control of the pressure-time course of oxygen use. At present, the pathogenesis and prevention of central nervous system oxygen toxicity are still the focuces and difficulties in the field of diving medicine. This article summarizes the pathogenesis and prevention measures of central nervous system oxygen toxicity recently reported by domestic and foreign literatures, so as to provide references for clinical and scientific research in this area.
Key words:  central nervous system diseases  oxygen toxicity  oxidative stress  neurotransmitter  adenosine  nitric oxide