一种麻药使一个女人的血变蓝了

一种麻药使一个女人的血变蓝了

A 25-year-old woman walked into an emergency department in Providence, Rhode Island, complaining of generalized weakness, fatigue, shortness of breath... and an unusual symptom you don't see every day.

一名25岁的女子走进罗德岛州普罗维登斯市的急诊室，抱怨全身虚弱、乏力、呼吸急促……这种不寻常的症状不是每天都能看到的。

She was turning blue.

她身体发青。

Drs. Otis Warren and Benjamin Blackwood wrote about the case in a study published in the New England Journal of Medicine on Thursday.

奥蒂斯·沃伦博士和本杰明·布莱克伍德博士于周四发表在《新英格兰医学杂志》上的一项研究中写道这一病例。

They attributed her blueness to a numbing agent the woman was using, which deadens nerve endings in the skin.

他们将她全身发蓝归因于她使用的一种麻醉剂，这种麻醉剂会使皮肤中的神经末梢麻木。

"She reported having used large amounts of topical benzocaine the night before for a toothache," the two co-authors wrote.

“她报告说，前一天晚上她用了大量局部苯佐卡因治疗牙痛，”两位合著者写道。

Warren, an emergency medicine physician at Miriam Hospital in Providence, told CNN he'd only ever seen one other "blue" patient while completing his residency. It stuck with him, so he was immediately able to identify the woman's condition.

沃伦是普罗维登斯市米里亚姆医院的急诊医生，他告诉CNN，他在完成住院医生实习期间只见过一位“蓝色”病人。这让他难以释怀，所以他很快就能确定这名女子的病情。

"It's one of those rare cases that we're taught about, you study for, you take tests on, but you rarely ever see," he told CNN.

他在接受CNN采访时表示:“这是我们所学到的罕见案例之一，你要为之学习，要参加考试，但你很少看到。”

Her condition kept blood from tissue

她的病情使血液无法进入组织

Warren diagnosed her with "acquired methemoglobinemia," a reaction caused by certain medicines that stops blood from carrying oxygen to tissue, he said.

沃伦诊断她患有“获得性高铁血红蛋白血症”，他说，这是一种由某些药物引起的反应，可以阻止血液向组织输送氧气。

Blood binds with oxygen and doesn't release it to the tissue where it's needed. And thus, the patient appears blue.

血液与氧气结合，不把氧气释放到需要氧气的组织中。因此，病人血液呈现蓝色。

The antidote is a brilliant blue, too. Methylene blue returns a missing electron to the hemoglobin molecule that restores oxygen levels and helps release oxygen back into tissue, he said.

解药也是一种亮蓝色。亚甲基蓝将缺失的电子返回到血红蛋白分子中，血红蛋白分子可以恢复氧气水平，并帮助将氧气释放回组织中，他说。

"In my field, emergency medicine, when you can cure a patient with a single antidote--that's a rare thing for us," he said.

他说:“在我的急诊医学领域，你可以用只一种解药治愈病人，这对我们来说是很罕见的。”

In his patient's case, her reaction was caused by benzocaine, an active ingredient found in cold sore medicine. And while hers is a rare side effect, it warranted a warning from the Food and Drug Administration, which cautioned against its use in children under 2, who sometimes take the medicine to soothe teething pain.

在他的病人身上，她的反应是由苯佐卡因引起的，苯佐卡因是一种存在于感冒药中的活性成分。虽然她的副作用很少见，但美国食品和药物管理局对此提出了警告，该机构告诫2岁以下儿童不要使用这种药物，因为他们有时会服用这种药物来缓解牙齿疼痛。

Warren's patient recovered after two doses of methylene blue and an overnight stay at the hospital. But when levels of the mutated blood rise 50% or higher, patients can enter a coma or develop heart and brain complications from the lack of blood to tissue. Any amount over 60% can cause death, he said.

沃伦的病人服用了两剂亚甲蓝，并在医院住了一晚，后来才康复。但是，当变异血液的水平上升到50%或更高时，患者可能会进入昏迷状态，或因组织中缺乏血液而出现心脏和大脑并发症。他说，当变异血液的水平上升到60%以上的任何水平时都可能导致死亡。