Abstract：Long-term nitrous oxide (N2O) exposure can cause neurological damage mainly manifested as spinal cord lesions. Patients generally have a gradual onset and progressive condition. The clinical manifestations are limb paresthesia and ataxia, some patients have symptoms of peripheral nerve injuries and extrapyramidal tracts injuries, it may cause cognitive dysfunction and mental abnormalities. Since the increase in clinical case reports of N2O abuse, it is of great significance to research the effects of N2O exposure on the nervous system. Therefore, after a systematic review of related literature and case reports, this paper summarizes the injury mechanism, clinical manifestations, exposure methods, diagnosis, treatment and prognosis of N2O exposure. We hope to strengthen the awareness of the disease, and to provide some ideas for diagnosis and treatment.
李依娜1 李明阳1 肖哲曼2 梁静静2. 一氧化二氮暴露对神经系统的影响进展[J]. 中国医药导报, 2020, 17(28): 36-39.
LI Yi′na1 LI Mingyang1 XIAO Zheman2 LIANG Jingjing2. Progress in the effects of nitrous oxide exposure on the nervous system. 中国医药导报, 2020, 17(28): 36-39.
[1] 刘志蓉，张添怿.一氧化二氮中毒致神经系统损害临床表现及防治展望[J].内科理论与实践，2018，13：261-263.
[2] Lew V，Mckay E，Maze M. Past，present，and future of nitrous oxide [J]. Br Med Bull，2018，125（1）：103-119.
[3] Lan SY，Kuo CY，Chou CC，et al. Recreational nitrous oxide abuse related subacute combined degeneration of the spinal cord in adolescents-A case series and literature review [J]. Brain Dev，2019，41（5）：428-435.
[4] van Amsterdam J，Nabben T，van den Brink W. Recreational nitrous oxide use：Prevalence and risks [J]. Regul Toxicol Pharmacol，2015，73（3）：790-796.
[5] Pugliese RS，Slagle EJ，Oettinger GR，et al. Subacute combined degeneration of the spinal cord in a patient abusing nitrous oxide and self-medicating with cyanocobalamin [J]. Am J Health Syst Pharm，2015，72（11）：952-957.
[6] Potocka-Banas B，Majdanik S，Dutkiewicz G，et al. Death caused by addictive inhalation of nitrous oxide [J]. Hum Exp Toxicol，2011，30（11）：1875-1877.
[7] Hathout L，El-Saden S. Nitrous oxide-induced B12 deficiency myelopathy：Perspectives on the clinical biochemistry of vitamin B12 [J]. J Neurol Sci，2011，301（1/2）：1-8.
[8] Smith AD，Refsum H. Homocysteine，B Vitamins，and Cognitive Impairment [J]. Annu Rev Nutr，2016，36：211-39.
[9] Cousaert C，Heylens G，Audenaert K. Laughing gas abuse is no joke. An overview of the implications for psychiatric practice [J]. Clin Neurol Neurosurg，2013，115（7）：859-862.
[10] 王丽，范其江，董明睿，等.滥用笑气中毒致神经系统损害一例[J].中国现代神经疾病杂志，2016，16（8）：533-537.
[11] Singh SK，Misra UK，Kalita J，et al. Nitrous oxide related behavioral and histopathological changes may be related to oxidative stress [J]. Neurotoxicology，2015，48：44-49.
[12] Gursoy AE，Kolukisa M，Babacan-Yildiz G，et al. Subacute Combined Degeneration of the Spinal Cord due to Different Etiologies and Improvement of MRI Findings [J]. Case Rep Neurol Med，2013，2013：159649.
[13] 冯雪丹，于莎莎，陈建华，等.氧化亚氮中毒致中枢神经系统损害6例临床分析及文献复习[J].疑难病杂志，2018， 17（11）：1276-1279.
[14] 王云云，汪仁斌，洪闻，等.滥用一氧化二氮致长节段脊髓病变的临床分析[J].北京大学学报：医学版，2019， 51：288-292.
[15] Dong X，Ba F，Wang R，et al. Imaging appearance of myel-opathy secondary to nitrous oxide abuse：a case report and review of the literature [J]. Int J Neurosci，2019，129（3）：225-229.
[16] Itoh T，Imano M，Nishida S，et al. （-）-Epigallocatechin-3-gallate increases the number of neural stem cells around the damaged area after rat traumatic brain injury [J]. J Neural Transm （Vienna），2012，119（8）：877-890.
[17] 董明睿，王丽，孙青，等.一氧化二氮滥用所致周围神经病的神经电生理特点[J].中国神经免疫学和神经病学杂志，2019，26（2）：116-120，125.
[18] Zheng D，Ba F，Bi G，et al. The sharp rise of neurological disorders associated with recreational nitrous oxide use in China： a single-center experience and a brief review of Chinese literature [J]. J Neurol，2020，267（2）：422-429.
[19] Bao L，Li Q，Li Q，et al. Clinical，Electrophysiological and Radiological Features of Nitrous Oxide-Induced Neurological Disorders [J]. Neuropsychiatr Dis Treat，2020，16：977-984.
[20] Oussalah A，Julien M，Levy J，et al. Global Burden Related to Nitrous Oxide Exposure in Medical and Recreational Settings：A Systematic Review and Individual Patient Data Meta-Analysis [J]. J Clin Med，2019，8（4）：551.
[21] Onrust MR，Frequin ST. Subacute Combined Spinal Cord Degeneration by Recreational Laughing Gas （N2O） Use [J]. J Cent Nerv Syst Dis，2019，11：1179573519838277.
[22] Cheng HM，Park JH，Hernstadt D. Subacute combined degeneration of the spinal cord following recreational nitrous oxide use [J]. BMJ Case Rep，2013，2013：bcr20120 08509.
[23] Chen HJ，Huang CS. Nitrous Oxide-induced Subacute Combined Degeneration Presenting with Dystonia and Pseudoathetosis：A Case Report [J]. Acta Neurol Taiwan，2016，25（2）：50-55.
[24] Garakani A，Jaffe RJ，Savla D，et al. Neurologic，psychiatric，and other medical manifestations of nitrous oxide abuse： A systematic review of the case literature [J]. Am J Addict，2016，25（5）：358-369.
[25] Fang X，Li W，Gao H，et al. Skin hyperpigmentation：a rare presenting symptom of nitrous oxide abuse [J]. Clin Toxicol （Phila），2020，58（6）：476-481.
[26] Sleeman I，Wiblin L，Burn D. An unusual cause of falls in a young woman [J]. J R Coll Physicians Edinb，2016， 46（3）：160-162.
[27] Layzer RB. Myeloneuropathy after prolonged exposure to nitrous oxide [J]. Lancet，1978，2（8102）：1227-1230.
[28] Massey TH，Pickersgill TT，Peall KJ. Nitrous oxide misuse and vitamin B12 deficiency [J]. BMJ Case Rep，2016，2016：bcr2016215728.
[29] Yuan JL，Wang SK，Jiang T，et al. Nitrous oxide induced subacute combined degeneration with longitudinally extensive myelopathy with inverted V-sign on spinal MRI：a case report and literature review [J]. BMC Neurol，2017，17（1）：222.
[30] 陶东霞，姜季委，李美欣，等.笑气中毒导致脊髓病变的临床分析[J].中风与神经疾病杂志，2019，36（4）：335-339.
[31] 姜明，胡洪涛，闫欣，等.亚急性联合变性病程不同时期MRI上病灶出现率及临床表现的差别[J].中风与神经疾病杂志，2013，30（3）：222-225.
[32] Li HT，Chu CC，Chang KH，et al. Clinical and electrodiagnostic characteristics of nitrous oxide-induced neuropathy in Taiwan [J]. Clin Neurophysiol，2016，127（10）：3288-3293.
[33] Richardson PG. Peripheral neuropathy following nitrous oxide abuse [J]. Emerg Med Australas，2010，22（1）：88-90.
[34] 黄绍磊，胡怀珍，袁冉冉，等.吸入笑气致脊髓亚急性联合变性案[J].中国针灸，2017，37（7）：734.
2020, Vol. 17 
京公网安备 11010502046598号