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目的:探讨高压氧(HBO)治疗对急性一氧化碳(CO)中毒大鼠下丘脑-垂体-肾上腺(HPA)轴的作用。方法:将36只大鼠按照随机数字表法分为正常对照组、CO中毒组和HBO治疗组各12只。建立急性CO中毒大鼠模型，给予HBO治疗7 d后，采用转录组测序(RNA-seq)进行各组大鼠脑组织基因检测，采用实时定量PCR(RT-PCR)对RNA-seq检测的差异基因阿片黑素促皮质激素原(POMC)进行分析；采用酶联免疫吸附法检测大鼠血清促肾上腺皮质激素(ACTH)和皮质醇(COR)的水平；采用免疫组化和免疫印迹法检测大鼠脑内POMC蛋白和ACTH蛋白受体(ACTHR)的表达。结果:RNA-seq和RT-PCR结果显示，CO中毒7 d后，大鼠下丘脑POMC基因表达显著升高(n P<0.05)，HBO处理使其表达降低(n P<0.05)。与对照组相比，CO中毒组大鼠大脑皮层POMC表达升高(n P<0.05), HBO治疗组较CO中毒组表达减少(n P<0.05)；CO中毒组大鼠大脑皮层ACTHR表达升高(n P0.05)。血清ACTH和COR水平检测结果显示，CO中毒组ACTH和COR显著增加(n P<0.05)，HBO治疗使其水平降低(n P<0.05)。n 结论:急性CO中毒可通过POMC-ACTH-COR途径激活HPA轴，HBO可能通过抑制HPA轴上相关基因、蛋白和激素水平的过度激活而发挥治疗作用。“,”Objective:To investigate the effects of hyperbaric oxygen (HBO) on the hypothalamic-pituitary-adrenal (HPA) axis in rats with acute carbon monoxide (CO) poisoning.Methods:Rat models with acute CO poisoning were established and treated with HBO for 7 days. RNA-sequencing (RNA-seq) was used to detect genes in the brain tissue of each group of rats, and real time quantitative PCR (RT-PCR) was adopted to analyze the pro-opiomelanocortin (POMC) of the genes that were differentiated by RNA-seq; the enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of rat serum adrenocorticotropic hormone (ACTH) and cortisol (COR); and immunohistochemistry (IHC) and western blot were applied to detect the expressions of POMC protein and ACTH protein receptor (ACTHR) in rats’ brain.Results:The results of RNA-seq and RT-PCR showed that 7 days after CO poisoning, the POMC gene expression in hypothalamus was significantly increased (n P<0.05), and its expression was downregulated by HBO treatment (n P<0.05). The results of IHC and western blot showed that, compared with the control group, POMC expressions in the cerebral cortex of the CO group were increased (n P<0.05), and POMC expressions in the HBO group were decreased (n P<0.05). ACTHR expressions were increased in the cerebral cortex of the CO group (n P<0.05), but there was no significant difference between the HBO group and the CO group (n P<0.05). The testing results showed that the levels of serum ACTH and COR in the CO group were significantly increased (n P<0.05), and were decreased after HBO treatment (n P<0.05).n Conclusion:Acute CO poisoning can activate the HPA axis through the POMC-ACTH-COR pathway, and HBO may exert a therapeutic effect by inhibiting the excessive activation of related genes, proteins, and hormones on the HPA axis.