高压氧联合醒脑静治疗急性一氧化碳中毒迟发脑病患者53例疗效观察  

Effect of hyperbaric oxygen combined with Xingnaojing injection on 53 patients with delayed encephalopathy caused by acute carbon monoxide poisoning

作　　者：秦慧[1] 吴海华 卢艳飞[1] 洪雁[1] 邓鹏洁 张元元[1] 欧阳国林 Qin Hui;Wu Haihua;Lu Yanfei;Hong Yan;Deng Pengjie;Zhang Yuanyuan;Ouyang Guolin(Department of Hyperbaric Oxygen,The First People’s Hospital of Nanning,Nanning 530022,China;Department of Internal Medicine(II),Guangxi Regional Corps Hospital of Chinese People’s Armed Police Force,Nanning 530003,China;Department of Emergency,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Naning 530011,China)

机构地区：[1]南宁市第一人民医院高压氧科,南宁530022 [2]武警广西总队医院内二科,南宁530003 [3]广西中医药大学附属瑞康医院急诊科,南宁530011

出　　处：《中华航海医学与高气压医学杂志》2022年第2期198-202,229,共6页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费项目(Z2016147)。

摘　　要：目的观察高压氧(HBO)联合醒脑静治疗对急性一氧化碳中毒迟发脑病(ACMPDE)患者血清神经损伤因子、血清炎症因子及认知功能的影响。方法选择2018年7月至2020年7月于南宁市第一人民医院治疗的106例ACMPDE患者作为研究对象, 按照随机数字表法分为研究组和对照组, 每组53例。对照组患者给予HBO治疗, 研究组患者在对照组治疗基础上联合醒脑静治疗, 连续治疗20 d。检测治疗前后2组患者C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、神经元特异性烯醇化酶(NSE)、5-羟色胺(5-HT)、血管生成素-2(Ang-2)、诱导型一氧化氮合酶(iNOS)、丙二醛(MDA)、超氧化物歧化酶(SOD)的水平;采用蒙特利尔认知评估量表(MoCA)、简易智力状态检查量表(MMSE)及健康调查简表(SF-36)评价2组患者认知功能和生活质量;比较2组患者治疗后临床疗效。结果治疗后, 研究组CRP、TNF-α、IL-6水平低于对照组(P<0.01), IL-10水平高于对照组(P<0.01), 5-HT水平高于对照组(P<0.01), NSE、Ang-2、iNOS水平低于对照组(P<0.01), SOD水平高于对照组(P<0.01), MDA水平低于对照组(P<0.01), MMSE、MoCA、SF-36评分高于对照组(P<0.01)。研究组治疗后总有效率(98.11%)明显高于对照组(84.91%), 差异有统计学意义(χ2=4.371, P=0.037)。结论 HBO联合醒脑静治疗可改善ACMPDE患者血清神经损伤因子水平, 抑制炎症反应, 减轻神经损伤, 降低氧化应激反应, 改善患者认知功能和生活质量, 值得临床推广应用。Objective To observe the effects of hyperbaric oxygen combined with Xingnaojing injection on serum nerve injury,serum factors,and cognitive function in patients with acute carbon monoxide poisoning delayed encephalopathy(ACMPDE).Methods A total of 106 cases with ACMPDE who were admitted to the First People’s Hospital of Nanning from July 2018 to July 2020 were selected as the research subjects and divided into control group and research group according to the random number table method,with 53 cases in each group.The control group was given hyperbaric oxygen treatment for 20 days,while the research group was given Xingnaojing injection on the basis of the treatment in the control group for 20 days.The levels of hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),neuron specific enolase(NSE),5-hydroxytryptamine(5-HT),angiopoietin-2(Ang-2),inducible nitric oxide synthase(iNOS),malondialdehyde(MDA),superoxide dismutase(SOD)in the two groups were detected before and after treatment.The Montreal Cognitive Assessment Scale(MoCA),Mini-Mental State Examination(MMSE)and 36-Item Short Form Health Survey(SF-36)were used to evaluate the cognitive function and quality of life of the two groups of patients and to compare the clinical efficacy of the two groups after treatment.Results The levels of hs CRP,TNF-αand IL-6 in the research group were lower than those in the control group(P<0.01),the level of IL-10 in the research group was higher than that in the control group(P<0.01),the level of 5-HT in the research group was higher than that in the control group(P<0.01),the levels of NSE,Ang-2,and iNOS in the research group were lower than those in the control group(P<0.01),the level of SOD in the research group was higher than that in the control group(P<0.01),and the level of MDA in the research group was lower than that in the control group(P<0.01).The MMSE,MOCA and SF-36 scores of the research group were higher than those of the control group(P<0.01).After tr

关 键 词：高压氧 醒脑静 急性一氧化碳中毒迟发脑病 

分 类 号：R595.1[医药卫生—内科学] R747.9[医药卫生—临床医学]