高压氧治疗联合奥拉西坦对职业性一氧化碳中毒患者HIF-1α、nNOS表达的影响  

Effects of hyperbaric oxygen therapy combined with Oxiracetam on HIF-1αand nNOS expression in patients with occupational carbon monoxide poisoning

作　　者：王磊[1] 杜立燕 陈怡 WANG Lei;DU Liyan;CHEN Yi(Hyperbaric Oxygen Treatment Room,Xiangyang Central Hospital,Affiliated Hospital Hubei University of Arts and Science,Hubei 441000,China;不详)

机构地区：[1]襄阳市中心医院/湖北文理学院附属医院高压氧治疗室,湖北441000 [2]襄阳市职业病防治院职业病科

出　　处：《工业卫生与职业病》2023年第5期394-397,共4页Industrial Health and Occupational Diseases

基　　金：湖北省卫生健康委员会科研项目(WJ2019F085)。

摘　　要：目的探讨高压氧治疗联合奥拉西坦治疗职业性CO中毒的临床疗效及对缺氧诱导因子-1α(HIF-1α)与神经源性一氧化氮合酶(nNOS)表达的影响。方法选取2016年1月-2020年12月收治的150例职业性CO中毒患者,随机将其分为对照组与研究组,每组各75例。对照组采取高压氧治疗,研究组联合奥拉西坦治疗。评估其临床疗效及安全性,比较两组住院时间及迟发性脑病发生率及两组治疗前后运动功能、认知能力、血清中HIF-1α与nNOS水平。结果研究组患者治疗总有效率(97.33%)较对照组(88.00%)显著升高(Z=4.807,P<0.05)。研究组患者住院时间与迟发性脑病发生率显著少于对照组(P<0.05)。两组治疗后HIF-1α[研究组(69.56±7.72)pg/mL比(114.37±12.11)pg/mL,对照组(78.12±8.18)pg/mL比(115.55±11.26)pg/mL]与nNOS[研究组(4.10±0.66)pg/mL比(5.60±1.10)pg/mL,对照组(4.82±0.79)pg/mL比(5.54±1.19)pg/mL]水平显著低于治疗前(t_(HIF-1α)=27.021和23.291,t_(nNOS)=10.127和4.365,P<0.05),研究组患者显著低于对照组(t=6.591和6.057,P<0.05),两组患者治疗后蒙特利尔认知评估量表(MOCA)[研究组(27.37±1.61)分比(22.56±2.79)分,对照组(25.68±1.34)分比(23.02±2.28)分]及运动功能量表(FMA)[研究组(54.00±2.10)分比(39.00±3.20)分,对照组(52.84±2.19)分比(39.84±3.39)分]评分均显著高于治疗前(t_(MOCA)=8.711和12.932,t_(FMA)=33.939和27.896,P<0.05),研究组患者显著高于对照组(t=6.243和3.311,P<0.05)。两组均未见相关并发症及不良反应。结论高压氧联合奥拉西坦治疗职业性CO中毒疗效较佳,可显著降低患者HIF-1α、nNOS表达,改善认知功能及日常生活能力,减少迟发性脑病发生率。Objective To investigate the clinical efficacy of hyperbaric oxygen therapy combined with oxiracetam in the treatment of occupational carbon monoxide poisoning and its effect on the expression of hypoxia inducible factor-1α(HIF-1α)and neurogenic nitric oxide synthase(nNOS).Methods A total of 150 patients with occupational carbon monoxide(CO)poisoning treated in our hospital from January 2016 to December 2020 were randomly divided into control group and study group,with 75 cases in each group.The control group was treated with hyperbaric oxygen,and the study group was treated with oxiracetam on the basis of the control group.The clinical efficacy and safety of the two groups were evaluated.The hospitalization time and the incidence of delayed encephalopathy were compared between the two groups.The motor function,cognitive ability,serum HIF-1αand nNOS level were compared between the two groups before and after treatment.Results The total effective rate of the observation group(97.33%)was significantly higher than that in the control group(88.00%)(Z=4.807,P<0.05).The length of stay and the incidence of delayed encephalopathy in the study group were significantly lower than those in the control group(P<0.05).The levels of serum HIF-1α[observation group(69.56±7.72)pg/mL vs(114.37±12.11)pg/mL,control group(78.12±8.18)pg/mL vs(115.55±11.26)pg/mL]and nNOS[observation group(4.10±0.66)pg/mL vs(5.60±1.10)pg/mL,control group(4.82±0.79)pg/mL vs(5.54±1.19)pg/mL]level in the two groups were significantly lower than those before treatment(t_(HIF-1α)=27.021,23.291,t_(nNOS)=10.127,4.365,P<0.05),and the levels of serum HIF-1αand nNOS in the observation group were significantly lower than those in the control group(t=6.591,6.057,P<0.05);The scores of Montreal cognitive assessment scale(MoCA)[observation group(27.37±1.61)scores vs(22.56±2.79)scores,control group(25.68±1.34)scores vs(23.02±2.28)scores]and motor function scale(FMA)[observation group(54.00±2.10)scores vs(39.00±3.20)scores,control group(52.84±2.19)sc

关 键 词：高压氧 奥拉西坦 职业性一氧化碳中毒 缺氧诱导因子-1Α 神经源性一氧化氮合酶 

分 类 号：R595.1[医药卫生—内科学]