醒脑静注射液联合亚甲基蓝治疗DECAMP的疗效及对患者脑脊液髓鞘碱性蛋白水平的影响

Therapeutic effect of Xingnaojing injection combined with methylene blue on DECAMP and the effect on the level of myelin basic protein in cerebrospinal fluid of patients

目的探讨醒脑静注射液联合亚甲基蓝(MB)对急性一氧化碳中毒迟发性脑病(DECAMP)的疗效及对患者脑脊液髓鞘碱性蛋白(MBP)水平的影响。方法选取该院收治的120例DECAMP患者为研究对象,将其按随机数字表法分为对照组和观察组,每组60例。对照组患者在常规治疗的基础上采用高压氧治疗,观察组患者在对照组的基础上加用醒脑静注射液联合MB治疗。采用简易智力状态检查量表(MMSE)评估两组患者治疗前、治疗后2周、治疗后1个月的认知功能。采用美国国立卫生研究院卒中量表(NIHSS)评估两组患者治疗前、治疗后2周、治疗后1个月的神经功能。采用酶联免疫吸附试验检测两组患者治疗前、治疗后1个月脑脊液MBP水平。治疗后1个月,统计两组患者不良反应发生率。结果治疗后2周、治疗后1个月两组患者MMSE评分均高于治疗前,NIHSS评分均低于治疗前,且观察组MMSE评分均高于对照组,NIHSS评分均低于对照组,差异有统计学意义(P<0.05)。治疗后1个月两组患者脑脊液MBP水平均较治疗前降低,且观察组脑脊液MBP水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后1个月,对照组患者中发生不良反应的有7例,占11.7%,观察组患者中发生不良反应的有4例,占6.7%,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论醒脑静注射液联合MB治疗可明显改善DECAMP患者的认知功能和神经功能,安全性高,具有较高的临床应用和推广价值。

Objective To explore the effect of Xingnaojing injection combined with methylene blue(MB)on delayed encephalopathy after acute carbon monoxide poisoning(DECAMP)and the effect on the level of myelin basic protein(MBP)in cerebrospinal fluid of patients.Methods A total of 120 DECAMP patients admitted to the hospital were selected as the study subjects and divided into control group and observation group according to random number table method,with 60 cases in each group.The patients in the control group were treated with hyperbaric oxygen on the basis of conventional treatment,while the patients in the observation group were treated with Xingnaojing injection combined with MB on the basis of the control group.The cognitive function of patients in the two groups was evaluated by the Mini-mental State Examination(MMSE)before treatment,two weeks after treatment and one month after treatment.The neurological function of the two groups of patients was evaluated by the National Institutes of Health Stroke Scale(NIHSS)before treatment,two weeks after treatment and one month after treatment.The level of MBP in cerebrospinal fluid of patients in both groups before treatment and one month after treatment was detected by enzyme-linked immunosorbent assay.One month after treatment,the incidence of adverse reactions in the two groups was counted.Results Two weeks and one month after treatment,the MMSE scores of patients in both groups were higher than those before treatment,and the NIHSS scores of patients in both groups were lower than those before treatment,the MMSE score of patients in the observation group was higher than that in the control group,and the NIHSS score was lower than that in the control group,the differences were statistically significant(P<0.05).One month after treatment,the level of cerebrospinal fluid MBP in both groups was lower than that before treatment,and the level of cerebrospinal fluid MBP in the observation group was significantly lower than that in the control group,the differences were statistically significant(P<0.05).One month after treatment,there were 7 cases with adverse reactions in the control group,accounting for 11.7%,and 4 cases with adverse reactions in the observation group,accounting for 6.7%,there was no significant difference on the incidence of adverse reactions between the two groups(P>0.05).Conclusion Xingnaojing injection combined with MB could significantly improve cognitive and neurological function in patients with DECAMP,with high safety,and has high clinical application and promotion value.