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Abstract：
Methemoglobinemia usually results from exposure to oxidizing substances such as nitrates or nitrites. Iron within hemoglobin is oxidized from the ferrous (Fe2+) state to the ferric (Fe3+) state, resulting in the inability to transport oxygen and carbon dioxide. Clinically, this condition causes functional cyanosis. As methemoglobin levels increase, patients show evidence of cellular hypoxia in all tissues. Death usually occurs when methemoglobin fractions approach 70% of total hemoglobin. We describe the case of a 35-year-old female patient with severe life-threatening isobutyl nitrite-induced methemoglobinemia of 75% of total hemoglobin. Toluidine-blue was administered as first-line antidotal therapy immediately, followed by hyperbaric oxygenation. The patient recovered uneventfully and could be discharged 3 days later.
摘要：
高铁血红蛋白血症通常由暴露于氧化物质如硝酸盐或亚硝酸盐引起。血红蛋白中的铁从亚铁（Fe2+）态氧化为三价铁（Fe3+）态，导致无法运输氧气和二氧化碳。临床上,这种情况会导致功能性紫癜。随着高铁血红蛋白水平的升高,患者显示所有组织中细胞缺氧的证据。当高铁血红蛋白分数接近总血红蛋白的70％时，通常会发生死亡。我们描述了一名35岁的女性患者，其严重危及生命的亚硝酸异丁酯引起的高铁血红蛋白血症占总血红蛋白的75％。立即给予甲苯胺蓝作为一线解毒疗法，其次是高压氧。患者恢复顺利，3天后可出院。
