急性一氧化碳中毒迟发性脑病患者血清肾上腺皮质激素释放激素、一氧化氮合成酶及5-羟色胺水平变化及意义

Change and significance of serum levels of CRH, NOS and 5-HT in acute carbon monoxide poisoning patients with delayed encephalopathy

选择急性一氧化碳中毒迟发性脑病（DEACMP）患者42例,急性一氧化碳中毒（ACOP）患者40例和正常对照组40例,比较两组相关激素水平的差异.结果显示,DEACMP组和ACOP组急性期与正常对照组比较血清促肾上腺皮质激素释放激素（CRH）、一氧化氮合成酶（NOS）显著升高,而5-羟色胺显著降低（P＜0.05）,DEACMP组和ACOP组之间差异有统计学意义（P＜0.05）.经治疗后恢复期DEACMP组和ACOP组与其急性期比较,血清CRH、NOS显著下降而5-羟色胺水平显著升高（P＜0.05）.DEACMP组急性期常识记忆注意测试评分（IMCT）、长谷川痴呆量表（HDS）评分显著低于ACOP组,日常生活能力量表（ADL）评分显著高于ACOP组（P＜0.05）.治疗后DEACMP组恢复期IMCT、HDS评分显著升高,ADL评分显著降低（P＜0.05）.CRH与NOS呈正相关,与5-羟色胺呈负相关（P＜0.05）.

To explore the change and significance of serum levels of corticotropin releasing hormone （CRH）,nitric oxide synthase （NOS） and 5-hydroxytryptamine （5-HT） in the pathogenesis of acute carbon monoxide poisoning delayed encephalopathy （DEACMP）.The groups of DEACMP （n =42）,acute carbon monoxide poisoning （ACOP） （n =40） and normal control （n =40） were selected.The peripheral blood levels of CRH,NOS and 5-HT were measured for acute and convalescent phases of three groups.Information-memory-concentration test （IMCT）,activities of daily living （ADL） and Hasegawa＇s dementia scale （HDS） were used to evaluate the intelligent state of acute and convalescent phases.When DEACMP and ACOP groups in acute phase were compared with normal control group,the serum levels of CRH and NOS significantly increased while the serum level of 5-HT decreased markedly （P ＜ 0.05）.And statistically significant difference existed between DEACMP and ACOP groups （P ＜ 0.05）.After treatment,the serum levels of CRH and NOS significantly decreased while the serum level of 5-HT increased markedly in DEACMP and ACOP groups in convalescent phase （P ＜ 0.05）.The IMCT and HDS scores of acute phase DEACMP group were significantly lower than those of ACOP group while ADL was significantly higher （P ＜0.05）.After treatment,the scores of IMCT and HDS increased and ADL decreased in DEACMP group in convalescence （P ＜ 0.05）.CRH was correlated positively with NOS （P ＜ 0.05） and negatively with 5-HT （P ＜ 0.05）.Hypothalamic-pituitary-adrenal cortical axis,NO-NOS system and the presence of 5-HT may be related with the pathogenesis of DEACMP.