脑苷肌肽对急性一氧化碳中毒迟发性脑病患者Ang-2、5-HT水平的影响

Effect of Cattle Encephalon Glycoside on Ang-2G 5-HT level in patients with delayed encephalopathy after acute carbon monoxide poisoning

目的研究脑苷肌肽治疗急性一氧化碳中毒迟发性脑病（delayed encephalopathy after acute carbon monoxide poisoning，DEACMP）的疗效及对血管生成素-2（angiopoietin-2，Ang2）、5-羟色胺（5-hydroxytryptamine，5-HT）水平的影响。方法将选自2014年11月-2018年2月期间河北医科大学附属哈励逊国际和平医院急诊科收治的DEACMP轻症患者104例随机分为观察组和对照组。对照组给予常规治疗，观察组在此基础上，加用脑苷肌肽10mL＋5％葡萄糖注射液250mL静脉滴注，1次／d。治疗2个疗程。观察治疗前后神经元特异性烯醇化酶、S-10013蛋白（S-10013）以及血管生成素-2（angiopoietin-2，Ang2）、5-羟色胺（5-hydroxvtryptamine，5-HT）水平。治疗前后用蒙特利尔认知评估量表及简易精神状态检查量表进行评分。结果治疗前，两组NSE、S-10015、Ang-2、5-HT、MoCA、MMSE比较差异无统计学意义（P〈0．05）。治疗后NSE、S-10013、Ang-2均低于治疗前，且治疗组低于对照组，差异有统计学意义（P〈0.05）。治疗后两组5-HT水平较治疗前改善，而治疗组升高幅度更大，差异有统计学意义（P〈0．05）。治疗后MoCA、MMSE评分均升高，治疗组明显高于对照组，差异有统计学意义（P〈0．05）。结论早期脑苷肌肽治疗DEACMP，降低Ang-2，升高5-HT，有效改善患者临床症状。

Objective To study the therapeutic effect of Cattle Encephalon Glycoside on delayed encephatopathy caused by acute carbon monoxide poisoning （DEACMP） and its effect on the level of angiopoietin-2 （Ang2）-5-hydroxytryptamine （5-HT）. Methods 104 patients with DEACMP were randomly divided into observation group and control group. The control group was given conventional treatment, while the observation group was given intravenous injection of Cattle Encephalon Glycoside 10ml 5%, Glucose Injection 250ml, and 1/d. for 2courses.The levels of neuron-specific enolase （NSE）, S-100 β protein （S-100 β） and angiopoietin 2 （Ang2） and serotonin （5-HT） were observed before and after treatment. Montreal Cognitive Assessment scale （MoCA） and Mini-Mental State scale （MMSE） were used before and after treatment, Results Before treatment, there was no significant difference in NSE, S-10013,Ang-2.5-HT.MoCA,MMSE between the two groups （P 〉 0.05）. After treatment, the levels of NSE,S-100]3, Ang-2in the treatment group were lower than those in the control group （P 〈 0.05）. After treatment, the 5-HT level of the two groups improved compared with that before treatment, while the treatment group increased more significantly （P 〈 0.05）, After treatment, the MMSE scores of MoCAG were significantly higher in the treatment group than in the control group （P 〈 0.05）. Conclusion The early treatment of DEACMP, the decreasement of Ang-2 and the increasement of 5-HT, can effectively improve the clinical symptoms of DEACMP.