胞磷胆碱辅助高压氧治疗CO中毒致急性脑缺氧患者疗效

Curative effect of citicoline-assisted hyperbaric oxygen on patients with acute cerebral hypoxia induced by CO poisoning

目的 探讨胞磷胆碱辅助高压氧治疗一氧化碳(CO)中毒致急性脑缺氧患者疗效及对血清和肽素、血清S100B蛋白和神经胶质纤维酸性蛋白(GFAP)水平的影响。方法 回顾性分析2017年12月—2021年1月在我院治疗的106例CO中毒致急性脑缺氧患者一般临床资料,根据治疗方式将采用高压氧治疗者纳入对照组(n=49),将采用胞磷胆碱辅助高压氧治疗者纳入观察组(n=57)。对比两组疗效,并记录两组治疗后血清和肽素、S100B蛋白、GFAP、神经功能缺损程度评分(NDF)、生活能力、心肌损伤指标及血液流变学指标变化情况,观察不良反应发生情况。结果 观察组治疗有效率高于对照组(P<0.05);治疗后两组NDF评分显著降低,BI指数升高,观察组治疗后NDF评分低于对照组,BI指数高于对照组(P<0.05);治疗后两组cTnT、CK-MB、AST均显著降低,且观察组以上指标明显低于对照组(P<0.05);治疗后两组全血高切黏度、全血低切黏度、血浆黏度均显著降低,且观察组以上指标明显低于对照组(P<0.05);治疗后两组血清和肽素、S100B蛋白、GFAP均显著降低,且观察组以上指标明显低于对照组(P<0.05);观察组不良反应发生率略高于对照组,差异无统计学意义(P>0.05)。结论 胞磷胆碱辅助高压氧治疗CO中毒致急性脑缺氧效果较佳,可显著降低患者脑神经功能缺损情况及心肌损伤,改善生活质量及血液流变学指标,可能与胞磷胆碱辅助高压氧治疗后降低和肽素、S100B蛋白、GFAP水平有关。

Objective To explore the curative effect of citicoline-assisted hyperbaric oxygen on patients with acute cerebral hypoxia induced by carbon monoxide(CO)poisoning and its influences on levels of serum copeptin,S100B protein and glial fibrillary acidic protein(GFAP).Methods A retrospective analysis was performed on the general clinical data of 106 patients with acute cerebral hypoxia induced by CO poisoning treated in the hospital from December 2017 to January 2021.According to different treatment methods,they were divided into control group(n=49,hyperbaric oxygen)and observation group(n=57,citicoline-assisted hyperbaric oxygen).The curative effect between the two groups was compared.The changes in serum copeptin,S100B protein,GFAP,neurological damage,activities of daily life,myocardial damage indexes and hemorheology indexes after treatment in both groups were recorded.The occurrence of adverse reactions was observed.Results The response rate of treatment in observation group was significantly higher than that in control group(98.25%vs 87.76%)(P<0.05).After treatment,NDF score was significantly decreased,while BI was increased in both groups.After treatment,NDF score in observation group was lower than that in control group,while BI was higher than that in control group(P<0.05).After treatment,cTnT,CK-MB and AST in both groups were significantly decreased,which were significantly lower in observation group than control group(P<0.05).After treatment,whole blood high-shear viscosity,whole blood low-shear viscosity and plasma viscosity in both groups were significantly decreased,which were significantly lower in observation group than control group(P<0.05).After treatment,levels of serum copeptin,S100B protein and GFAP in both groups were significantly decreased,which were significantly lower in observation group than control group(P<0.05).The incidence of adverse reactions in observation group was slightly higher than that in control group,but the difference was not statistically significant(P>0.05).Conclusion Curative effect of citicoline-assisted hyperbaric oxygen is significant on patients with acute cerebral hypoxia induced by CO poisoning,which can significantly reduce neurological damage and myocardial damage,improve quality of life and hemorheology indexes.Its mechanism may be related to reducing levels of copeptin,S100B protein and GFAP.