间歇长疗程高压氧联合单唾液酸四己糖神经节苷脂治疗一氧化碳中毒迟发性脑病的效果  

Intermittent Long-course Hyperbaric Oxygen Therapy Combined with Monosialotetrahexosyl Ganglioside for Delayed Encephalopathy after Acute Carbon Monoxide Poisoning

作　　者：王艳秋 闻晓庆 刘洋[1] 景少巍 骆图南 马遥 罗昕[1] 彭伟涛 欧阳晓春 WANG Yan-qiu;WEN Xiao-qing;LIU Yang;JING Shao-wei;LUO Tu-nan;MA Yao;LUO Xin;PENG Wei-tao;OUYANG Xiao-chun(Department of Neurology,the 908th Hospital of the Chinese People’s Liberation Army Joint Logistic Support Force,Nanchang 330002,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院神经内科,南昌330002

出　　处：《实用临床医学(江西)》2025年第1期6-10,共5页Practical Clinical Medicine

基　　金：江西省卫健委科技计划项目(20204803);联勤保障部队第九〇八医院苗子基金项目(2022YNKT028)。

摘　　要：目的 探讨间歇长疗程高压氧联合单唾液酸四己糖神经节苷脂(GM1)治疗一氧化碳中毒迟发性脑病(DEACMP)的临床效果。方法 选取2022—2024年就诊的65例DEACMP患者,根据治疗方法的不同,将其分为高压氧组(n=36)和联合组(n=29)。高压氧组在对症支持治疗的基础上,予间歇长疗程高压氧治疗,30次为一疗程,每日1次,共3个疗程,每疗程间隔2 d。联合组在高压氧组基础上联合GMI注射液(80 mg·次^(-1),每日1次;治疗3周后剂量调整为40 mg·次^(-1),每日1次,继续治疗6周)治疗。比较治疗前及每个疗程结束时2组日常生活功能障碍(BI)、简易智能精神状态检查量表(MMSE)评分;比较治疗前和3个疗程结束时2组血清IFN-γ和IL-10水平。结果 2组治疗后各观察时间点较治疗前BI、MMSE评分更优,IL-10水平明显升高(P <0.05),IFN-γ水平明显降低(P <0.05);且联合组BI、MMSE评分高于高压氧组(P <0.05),IFN-γ水平低于高压氧组,IL-10水平高于高压氧组(P <0.05)。结论 在对症支持治疗基础上,间歇长疗程高压氧联合GMI能改善DEACMP患者症状、减轻其神经损伤、恢复其神经功能。Objective To investigate clinical efficacy of the intermittent long-course hyperbaric oxygen therapy combined with monosialotetrahexosyl ganglioside in the management of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Methods 65 patients with DEACMP who visited our hospital from 2022 to 2024 were selected and divided into a hyperbaric oxygen group(n=36)and a combined treatment group(n=29)based on different treatment methods.On the basis of symptomatic supportive treatment,the hyperbaric oxygen group received intermittent long-course hyperbaric oxygen therapy,30 sessions per course,once daily,for a total of 3 courses with a 2-day interval between each course,whereas the combined treatment group,in addition to the hyperbaric oxygen regimen,received monosialotetrahexosyl ganglioside injection,with initial dose of 80 mg once daily for 3 weeks,followed by a reduced dose of 40 mg once daily for an additional 6 weeks.The scores of Barthel Index(BI)and Mini-Mental State Examination(MMSE)were compared between the 2 groups before treatment and at the end of each course of treatment.The levels of serum IFN-γand IL-10 were compared rd between the 2 groups before treatment and at the end of the 3 course.Results At each observation time point after treatment,both groups had better BI and MMSE scores,significantly higher levels of IL-10(P<0.05),and significantly lower levels of IFN-γ(P<0.05).The improvement in BI and MMSE scores in the combination group was Higher than that in the hyperbaric oxygen group(P<0.05);the IFN-γlevel in the combination group was lower than that in the hyperbaric oxygen group;the IL-10 level in the combination group was higher than that in the hyperbaric oxygen group(P<0.05).Conclusion Based on symptomatic supportive treatment,the intermittent long-course hyperbaric oxygen therapy combined with monosialotetrahexosyl ganglioside can potentially alleviate symptoms,reduce neural damage,and restore neural function in patients with DEACMP.

关 键 词：一氧化碳中毒 迟发性脑病 高压氧 单唾液酸四己糖神经节苷脂 炎症因子 

分 类 号：R742[医药卫生—神经病学与精神病学]