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Vol. 34. Issue 7.
Pages 339-343 (July - August 1998)
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Vol. 34. Issue 7.
Pages 339-343 (July - August 1998)
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Relación entre la exposición al humo del tabaco y las concentraciones de carboxihemoglobina y hemoglobina
Relation between tobacco smoke exposure and carboxyhemoglobin and hemoglobin levels
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L. Puente-Maestu*, N. Bahonza, M.C. Pérez, J.M. Ruiz de Oña, J.L. Rodríguez Hermosa, E. Tatay
Servicio de Neumología. Hospital General Universitario Gregorio Maruñón. Madrid
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Para determinar los intervalos de predicción del porcentaje de hemoglobina ligada a monóxido de carbono (CO-Hb) en los no fumadores y los fumadores pasivos y obtener una ecuación de la CO-Hb en función del número de cigarrillos fumados, estudiamos a 233 pacientes ambulantes enviados para gasometría arterial a un hospital universitario de un área urbana. No se incluyó a aquellos sujetos que estuviesen recibiendo cualquier modalidad de oxigenoterapia o hubiesen estado ingresados en los 2 meses previos. Se les clasificó en: a) no fumadores (57): b) fumadores pasivos (54); c) fumadores de < 11 cigarrillos (22); d) fumadores de 11-20 cigarrillos (41); e) fumadores de 21-40 cigarrillos (44), y f) fumadores de > 40 cigarrillos (15). A todos se les realizó un cuestionario sobre la exposición al humo del tabaco y a otras fuentes de CO, gasometría y cooximetría. La media de la CO-Hb en los no fumadores y los intervalos de predicción del 95% fueron del 1,53% (0,78-1,85%) y en los fumadores pasivos del 2,59% (1,89-3,29%). La relación lineal que mejor ajustaba, era: CO-Hb = 0,153 x número de cigarrillos + 1,1 exposición a otras fuentes (1 o 0) + 1,39 (0,84 DE)%. La Hb sanguínea fue significativamente mayor en los dos grupos de fumadores de > 21 cigarrillos que en los otros grupos. Concluimos que en los sujetos no fumadores, no expuestos a otras fuentes de CO, el límite superior del intervalo de predicción es del 1,9%. Los fumadores pasivos tienen concentraciones significativamente más altas de CO-Hb que los no fumadores, y los fumadores más intensos tienen policitemia.

Keywords:
Carboxyhemoglobin
Tobacco
Carbon monoxyde
Palabras clave:
Carboxihemoglobina
Tabaquismo
Monóxido de carbono

To determine the carboxyhemoglobin (CO-Hb) predictive intervals in active and passive smokers and to obtain an equation expressing the relation of CO-Hb to number of cigarettes smoked, we studied 233 outpatients referred to an urban university hospital for arterial gas measurement. Patients were excluded if they were receiving oxygen therapy or had been hospitalized in the two months before the study. The patients were classified as non smokers (57), passive smokers (54), smokers of less than 11 cigarettes (22), smokers of 11 to 20 (41) smokers of 21 to 40 (44) and smokers of over 40 (15). All patients answered a questionnaire on exposure to tobacco smoke or other sources of CO. Blood gases and co-oximetry were measured in all patients. Mean CO-Hb and 95% confidence intervals were 1.53% (0.78-1.85%) in smokers and 2.59% (1.89-3.29%) in passive smokers. The linear equation that best expressed the relationship was CO-Hb = 0.153 x number of cigarettes + 1.1 exposure to other sources (1 or 0) + 1.39 (SD 0.84)%. Hemoglobin level was significantly higher in the two groups smoking more than 21 cigarettes. We conclude that the predictive intervals is 1.9% in non smokers who are not exposed to other sources of CO. Passive smokers have significantly higher levels of CO-Hb than non smokers. Heavy smokers have polycythemia.

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