急性一氧化碳中毒后迟发性脑病患者血清醛固酮水平变化及其临床意义  

Change of Serum Aldosterone Level in Patients with Delayed Encephalopathy after Acute Carbon Monoxide Poisoning and Its Clinical Significance

作　　者：张延霞[1] 王冀康 顾家鹏 顾仁骏[1] 李静[3] 吴强[3] 何文龙[3] 田松朝[4] 

机构地区：[1]新乡医学院第二附属医院神经内科,河南省新乡市453002 [2]河南省生物精神病学重点实验室 [3]新乡市中心医院 [4]中国人民解放军371中心医院

出　　处：《中国全科医学》2012年第36期4172-4174,4177,共4页Chinese General Practice

基　　金：河南省医学科技攻关计划资助项目(200703079);新乡医学院研究生科研创新支持计划资助项目(YJSCX201007Y)

摘　　要：目的探讨急性一氧化碳中毒后迟发性脑病(DEACMP)患者血清醛固酮水平的变化及其临床意义。方法选取2004年11月—2006年2月新乡市5所医院收治的DEACMP患者33例(DEACMP组)及急性一氧化碳中毒(ACMP)患者32例(ACMP组),并将同期新乡医学院第二附属医院体检健康者32例作为正常对照组。采用酶联免疫吸附试验(ELISA)法动态检测3组受试者的血清醛固酮水平;并采用常识-记忆-注意测验(IMCT)、长谷川痴呆量表(HDS)、日常生活能力量表(ADL)动态评估DEACMP患者的病情变化;分析血清醛固酮水平与IMCT、HDS、ADL评分的关系。结果 DEACMP组急性期血清醛固酮水平高于ACMP组和正常对照组,ACMP组血清醛固酮水平亦高于正常对照组,差异均有统计学意义(P<0.05)。DEACMP组恢复期血清醛固酮水平〔(135±43)ng/L〕低于急性期〔(163±62)ng/L〕,差异有统计学意义(P<0.05)。DEACMP患者恢复期ADL评分较急性期减少,而HDS、IMCT评分较急性期增加,差异均有统计学意义(P<0.01)。DEACMP组血清醛固酮水平与HDS评分及ADL评分均呈正相关(P<0.05)。结论 DEACMP患者血清醛固酮水平显著增高;其动态变化与患者的病情变化基本一致,故动态检测血清醛固酮水平可以作为判定DEACMP患者病情变化和治疗效果的生物学指标之一。Objective To investigate the clinical significance of serum aldosterone （ALD） level in patients with de- layed encephalopathy after acute carbon monoxide poisoning （DEACMP） . Methods 33 DEACMP patients （ DEACMP group） admitted to five hospitals in Xinxiang and 32 patients who had acute carbon monoxide poisoning without DEACMP （ACMP group） from November 2004 to February 2006 were selected. Meanwhile, 32 healthy people underwent physical examination in the same period were selected as control group. ELISA method was used to dynamically detect serum ALD in the three groups. Information - memory- concentration test （IMCT）, Hasegawa＇s dementia scales （HDS） and the activity of daily living scale （ADL） were used to dynamically monitor DEACMP patients＇ condition. The correlation between serum ALD and scores of IMCT, HDS and ADL was analyzed. Results The serum ALD in DEACMP group at acute stage was significantly higher than that in ACMP group and control group （P 〈 0. 05 ）, and the ACMP group was also significantly higher than the control group （P 〈 0. 05） . The ser- um ALD in DEACMP group at convalescent stage [ （ 135 ±43） ng/L] was significantly lower than at acute stage [ （ 163±62） ng/L, P 〈 0.05 ] . Compared with acute stage, the ADL score of DEACMP patients at convalescent stage was significantly low- er, but the HDS and IMCT scores were significantly higher （P 〈0. 01 ） . In DEACMP group, the serum ALD was positively cor- related with HDS and ADL scores （P 〈 0. 05） . Conclusion Serum ALD is significantly increased in DEACMP patients and its dynamic changes are consistent with-the patients＇ condition. Therefore, dynamic monitoring of serum ALD can be regarded as a bi- ological indicator for the condition and treatment effect of DEACMP patients.

关 键 词：一氧化碳中毒 脑疾病 醛固酮 

分 类 号：R595.1[医药卫生—内科学]