METHAEMOGLOBINAEMIA DUE TO NITRATES AND NITRITES IN DRINKING-WATER
METHAEMOGLOBINAEMIA DUE TO NITRATES AND NITRITES IN DRINKING-WATER
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DOI：
10.1136/bmj.2.4887.575
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发表时间：
1954-01-01
影响因子：
105.7
通讯作者：
ALDRIDGE, AGV
中科院分区：
文献类型：
--
作者：
FAWNS, HT;ALDRIDGE, AGV
高铁血红蛋白在正常人的血液中可能有少量存在，实际范围在一定程度上取决于所采用的估计方法。Bodansky和Bodansky(1952)使用气体计量法引用了占总血红蛋白0.6%到1.8%(平均1.28%)的数值，而更常用的分光光度法在NaCN转化为氰化高铁血红蛋白后，得出的范围要小得多，范围为0到1.1%(平均为0.4%)。紫紫变得明显的程度将取决于患者的血红蛋白浓度，如果可利用的总血红蛋白较低，显然更容易发生。除了Breakey等人(1951年)和Codounis(1952)所描述的家族性特发性高铁血红蛋白血症的先天性疾病外，高铁血红蛋白血症可能是通过摄入许多有机和无机物质而获得的。饮用水中的亚硝酸盐是一个可能的来源，但很容易被忽视。硝酸盐也可以通过肠道细菌转化为亚硝酸盐而导致这种情况。Campbell(1952)从北爱尔兰报告了一例1个月大婴儿因饲料水中含有硝酸盐而发紫的病例。在婴儿中识别高铁血红蛋白形成所致的发紫是很重要的，因为这种情况最初可能被误认为是先天性心脏病之一。
Methaemoglobin may be present to a small extent in the blood of normal persons, the actual range found depending to some extent on the method of estimation employed. Bodansky and Bodansky (1952) quoted values ranging from 0.6 to 1.8% of the total haemoglobin (average 1.28%), using a gasometric method, while the more usual spectrophotometric method, after conversion by NaCN to cyanmethaemoglobin, gave the much lower range of 0 to 1.1%(average 0.4%). The level at which cyanosis becomes apparent will depend on the haemoglobin concentration of the patient, being obviously more apt to occur if the total available haemo-globin is low. The condition is exacerbated by anything which increases oxygen conisumption, such as heavy exercise or pyrexia.Apart from the congenital condition of familial idio-pathic methaemoglobinaemia, described by Breakey et al.(1951) and Codounis (1952), in which cyanosis is usually present from birth, methaemoglobinaemia may be acquired by the ingestion of a number of substances, both organic and inorganic. Nitrites in drinking-water are a possible source which may be easily overlooked. Nitrates can also cause the condition by being converted to nitrites by intestinal bacteria. Campbell (1952) reported from Northern Ireland a case of cyanosis in a 1-month-old infant due to nitrates in the water used to make up its feeds. Recognition in infants of cyanosis due to methaemoglobin formation is important, as the case may be initially mistaken for one of congenital heart disease.