高压氧联合胞磷胆碱对急性一氧化碳中毒迟发性脑病脑氧利用率、心肌组织损伤及相关指标的影响  

The effects of hyperbaric oxygen combined with citicoline on cerebral oxygen utilization and myocardial tissue injury in delayed cerebral dysfunction after acute CO poisoning

作　　者：马改亚 贺东红 张建 MA Gaiya;HE Donghong;ZHANG Jian(Yulin Hospital,First Affiliated Hospital of Xi’an Jiaotong University,Yulin 719000,China)

机构地区：[1]西安交通大学第一附属医院榆林医院,陕西榆林719000

出　　处：《陕西医学杂志》2025年第4期497-501,共5页Shaanxi Medical Journal

基　　金：陕西省自然科学基础研究计划(2020-JC-QN-0098,2021JM-625)。

摘　　要：目的:观察高压氧联合胞磷胆碱对急性一氧化碳(CO)中毒迟发性脑病(DEACMP)后脑氧利用率(O_(2) UCc)及心肌组织损伤的影响。方法:将80例DEACMP患者采用信封法分为两组。高压氧组采用高压氧治疗,联合组在其基础上联合胞磷胆碱治疗。检测两组O_(2) UCc、半胱氨酸天冬氨酸蛋白酶(Caspase)-3、Caspase-9、心肌酶、听觉事件相关电位(ERP)-P300、脑功能状态变化,评估两组简易精神状态量表(MMSE)评分、改良巴氏指数量表(MBI)评分差异。结果:治疗前比较,组间O_(2) UCc、Caspase-3、Caspase-9、心肌酶无统计学差异(均P>0.05)。治疗前后比较,两组乳酸脱氢酶(LDH)、O_(2) UCc、肌红蛋白(Mb)、Caspase-3、肌钙蛋白(cTnI)、Caspase-9、肌酸激酶(CK)均降低,且联合组较高压氧组更低(均P<0.05)。治疗前比较,组间ERP-P300无统计学差异(P>0.05)。治疗前后比较,两组ERP-P300潜伏期均降低,且联合组较高压氧组更低(P<0.05);两组ERP-P300波幅均升高,且联合组较高压氧组更高(P<0.05)。治疗前比较,组间脑功能状态指标无统计学差异(P>0.05)。治疗前后比较,两组睡眠呼吸指数、氧乏指数、脑惰性均升高,且联合组较高压氧组更高(均P<0.05)。治疗前比较,组间MMSE评分、MBI评分比较均无统计学差异(均P>0.05)。治疗前后比较,两组MMSE评分、MBI评分升高,且联合组较高压氧组更高(均P<0.05)。结论:高压氧联合胞磷胆碱治疗DEACMP可改善脑功能状态,减轻心肌损伤,提高自理能力。Objective:To observe the effect of hyperbaric oxygen combined with Citicoline on cerebral oxygen utilisation(O_(2) UCc)and myocardial tissue damage after delayed encephalopathy in acute carbon monoxide(CO)poisoning(DEACMP).Methods:A total of 80 DEACMP patients were randomly divided into two groups using the envelope method.The hyperbaric oxygen group received hyperbaric oxygen therapy,while the combination group received additional citicoline treatment on top of the hyperbaric oxygen therapy.The levels of O_(2) UCc,Caspase-3,Caspase-9,myocardial enzymes,auditory event-related potential(ERP)-P300,and changes in brain function status were measured in both groups.The differences in Mini-Mental State Examination(MMSE)scores and Modified Barthel Index(MBI)scores were evaluated between the two groups.Results:Before treatment,there were no statistically significant differences between the groups in terms of O_(2) UCc,Caspase-3,Caspase-9,and myocardial enzymes(all P>0.05).When comparing pre-and post-treatment results,both groups showed reductions in lactate dehydrogenase(LDH),O_(2) UCc,myoglobin(Mb),Caspase-3,cardiac troponin I(cTnI),Caspase-9,and creatine kinase(CK),with the combination group demonstrating significantly lower levels than the hyperbaric oxygen group(all P<0.05).Prior to treatment,no significant difference was observed in ERP-P300 between the groups(P>0.05).Post-treatment,both groups exhibited a reduction in ERP-P300 latency,with the combination group showing a more pronounced decrease compared to the hyperbaric oxygen group(P<0.05).Additionally,the ERP-P300 amplitude increased in both groups,with the combination group displaying a greater increase than the hyperbaric oxygen group(P<0.05).Before treatment,no significant differences were noted in brain function status indicators between the groups(P>0.05).After treatment,both groups experienced increases in sleep respiratory index,oxygen deficiency index,and brain inertia,with the combination group showing higher values than the hyperbaric oxygen group(all

关 键 词：高压氧 胞磷胆碱 急性一氧化碳中毒迟发性脑病 脑功能状态 听觉事件相关电位-300 心肌损伤 

分 类 号：R742[医药卫生—神经病学与精神病学]