颅脑CT预测急性一氧化碳中毒后迟发性脑病的价值  

The value of brain CT in predicting delayed encephalopathy after acute carbon monoxide poisoning

作　　者：丁世荣[1] 苟代文 王国俊[1] DING Shi-rong;GOU Dai-wen;WANG Guo-jun(Department of Radiology,People’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture,Sichuan Province,Aba 624000,China)

机构地区：[1]四川省阿坝藏族羌族自治州人民医院放射科,四川阿坝州624000

出　　处：《工业卫生与职业病》2021年第4期304-307,共4页Industrial Health and Occupational Diseases

摘　　要：目的探讨颅脑CT预测急性一氧化碳中毒后迟发性脑病(DEACMP)的价值。方法回顾性分析2017年1月至2019年1月我院收治并在入院后24h内行颅脑CT检查的急性CO中毒患者的一般资料和临床特征,计算综合CT评分进行半定量评估病情严重程度;所有患者随访6个月,比较DEACMP组和无DEACMP组患者临床资料和CT表现,绘制ROC曲线评估综合CT评分用于预测DEACMP的诊断效能。结果共纳入65名患者进行分析,DEACMP患者14例(21.54%),无DEACMP组患者51例(78.46%),两组患者一般资料和碳氧血红蛋白(COHb)比较,差异无统计学意义(P>0.05)。DEACMP组患者相比无DEACMP组的症状持续时间更长、CO接触的时间更长、急性生理和慢性健康评分(APACHE-II)更高,格拉斯哥昏迷评分(GCS)更低,严重症状者和脑CT异常的患者比例较高(81.5%vs 51.0%);DEACMP组的综合CT评分(73.63分)明显高于无DEACMP组(51.39分);ROC曲线用于评估综合CT评分在预测DEACMP中的效能,其曲线下面积(AUC)为0.700(95%CI:0.584~0.817;),差异均有统计学意义(P<0.01)。结论颅脑CT综合评分在预测DEACMP中具有重要价值,值得临床推广应用。Objective To investigate the value of computed tomography(CT)findings for the prediction of DEACMP.Methods The general data and clinical characteristics of patients with acute CO poisoning,who underwent brain CT examination within 24 hours after admission,in a hospital from January 2017 to January 2019 were retrospectively analyzed,and the integrated CT score was calculated to assessthe severity of the diseases.All patients were followed up for 6 months to compare the clinical data and CT performance of the patients in the DEACMP group and the group without DEACMP,and ROC was used to evaluate the integrated CT score to predict the diagnostic efficacy of DEACMP.Results A total of 65 patients were included for analysis,including 14 patients(21.54%)with DEACMP and 51 patients(78.46%)without DEACMP.There was no difference in general data and COHb between the two groups.The patients in the DEACMP group had longer symptom duration,longer CO exposure,higher acute physiological and chronic health score(APACHE-Ⅱ),lower Glasgow coma score(GCS),and higher proportion of patients with severe symptoms and abnormal brain CT(81.5%vs 51.0%)than those without DEACMP(allP<0.05).The comprehensive CT score of the DEACMP group was significantly higher than that of the group without DEACMP(73.63 vs 51.39,P<0.01).The ROC curve was used to evaluate the efficacy of comprehensive CT score in predicting DEACMP,and the AUC was 0.700(95%CI:0.584~0.817,P<0.01).Conclusion Brain integrated CT score has the potential to identify DEACMP in patients.

关 键 词：急性一氧化碳中毒 迟发性脑病 风险因素 计算机断层扫描(CT) 

分 类 号：R814.42[医药卫生—影像医学与核医学] R749.63[医药卫生—放射医学]