急性CO中毒后迟发性脑病的相关因素及P_(300)的研究  

Relative factors on the delayed encephalopathy after acute carbon monoxide poisoning and the study of P_(300)

作　　者：贾和平[1] 郑荣珍[2] 崔现[2] 李香月[2] 

机构地区：[1]河北省张家口市251医院神经内科,075000 [2]吉林省延边大学医学院附属医院

出　　处：《临床神经病学杂志》2002年第5期277-279,共3页Journal of Clinical Neurology

摘　　要：目的　探讨急性一氧化碳 (CO)中毒后迟发性脑病 (DEACMP)的相关因素及P3 0 0 对其病情判定和预后的意义。方法　对 4 4例DEACMP患者与 4 2例未发生迟发性脑病的急性CO中毒 (ACMP)患者在CO接触时间、昏迷时间等 13个方面进行比较 ,并行P3 0 0 检测 ,且与DEACMP组发生CO中毒初期清醒后所测P3 0 0(DEACMP0组 )及 4 4名正常人的P3 0 0 (NC组 )进行比较。结果　DEACMP在CO接触时间、昏迷时间、高压氧治疗时间、年龄、合并症等方面与ACMP组比较有极显著差异 (P <0 .0 1) ,在扩血管药治疗、心脑血管病及呼吸系统疾病史、吸烟、职业方面亦有显著差异 (P <0 .0 5 )。DEACMP组较DEACMP0组P3 0 0 潜伏期明显延长 ,波幅明显下降 (P <0 .0 1) ,DEACMP0组较NC组亦有类似改变。结论　长时间接触CO、长时间昏迷、高压氧治疗时间较短、扩血管药治疗时间短、年龄较大、有合并症、患心脑血管病及呼吸系统疾病、吸烟、脑力劳动与发生DEACMP相关。急性CO中毒患者的P3 0 0 潜伏期越长、波幅越低、其认知功能越差 ,发生DEACMP的可能性越大。P3 0 0 对DEACMP的发生。Objective To explore the relative factors on delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)and the signifiance of P 300 for judging the severity and prognosis of DEACMP.Methods Thirteen aspects such as contact time with carbon monoxide (CO)?coma time et al were analysed between 44 patients with DEACMP (DEACMP group)and 42 patients with acute CO poisoning but without DEACMP (ACMP group). P 300 s were studied in the patients with P 300 as compared with the patients had just caught acute CO poisoning (DEACMP group).and 44 normal controls (NC group).Results There was extremely significant difference in contact time with CO,coma lasting time,treatment time with hyperbaric oxygen,age,complication ( P <0.01).and there was marked difference in the application with vasodilator,history of cardiovascular/cerebrovascular disease and respiratory disease,smoke, occupation( P <0.05).The latency of P 300 was more prolonged significantly and the amplitude was lower in the DEACMP group than that in DEACMP0 group( P <0.01), the result was similar between DEACMP0 group and NC group.Conclusion Long contact time with CO,long lasting coma,short time with oxygen and vasodilator,elderly,complication,previously with cardiovascular and cerebrovascular disease and respiratory disease,smoke,mental work were proved to be the risk factors for the development of DEACMP.The more prolonged latency of P 300 s and the lower aptitude of P 300 s in the patients with DEACMP was,the worse cognition abiltity of the patients was,and the greater probability of the development of DEACMP was.P 300 s can evaluate exactly the development and the prognosis of DEACMP.

关 键 词：急性CO中毒 迟发性脑病 认知功能 P300 DEACMP 

分 类 号：R595.1[医药卫生—内科学]