依达拉奉联合甲泼尼龙治疗一氧化碳中毒迟发性脑病病人的疗效及对血清钙结合蛋白S100B、胱天蛋白酶-3水平的影响

Efficacy of edaravone combined with methylprednisolone on patients with delayed encephalopathy after acute carbon monoxide poisoning and its influences on serum calcium binding protein S100B and caspase-3 levels

目的 探讨依达拉奉联合甲泼尼龙治疗一氧化碳中毒迟发性脑病(DEACMP)病人的疗效及对血清钙结合蛋白S100B(S100B)、胱天蛋白酶-3(caspase-3)的影响。方法 回顾性分析2019年7月至2022年8月在保定市第二医院治疗的102例DEACMP病人的临床资料,将2019年7月至2021年2月的50例病人设为激素组,将2021年3月至2022年8月的52例病人设为联合组,均按方便抽样法抽取。所有病人均采取常规用药+高压氧治疗,激素组在此基础上应用甲泼尼龙治疗,联合组在激素组基础上采用依达拉奉治疗。比较两组疗效、治疗前后蒙特利尔认知评估量表(MoCA)评分、长谷川痴呆量表(HDS)评分、血清S100B、caspase-3水平及脑电图。结果 联合组总有效率92.31%明显高于激素组的74.00%(P<0.05);主体间效应检验显示治疗前MoCA、HDS评分、血清S100B、caspase-3水平高于治疗后1个月,两组治疗后1个月MoCA、HDS评分、血清S100B、caspase-3水平差异有统计学意义(P<0.05);联合组治疗后1个月脑电图明显优于激素组(P<0.05)。结论 对DEACMP病人实施依达拉奉联合甲泼尼龙治疗的效果确切,可有效下调血清S100B、caspase-3水平,明显减轻痴呆症状及认知障碍,显著改善脑电图。

Objective To investigate the curative effect of edaravone combined with methylprednisolone on patients with delayed en-cephalopathy after acute carbon monoxide poisoning(DEACMP)and its influences on serum calcium binding protein S100B(S100B)and caspase-3.Methods The clinical data of 102 patients with DEACMP treated in The No.2 Hospital of Baoding from July 2019 to August 2022 were retrospectively analyzed,among which 50 patients randomly selected by convenient sampling method from July 2019 to February 2021 were set as the hormone group,and the other 52 patients randomly selected according to convenient sampling method from March 2021 to August 2022 were set as the combined group.All patients were treated with conventional medication plus hyperbar-ic oxygen therapy,the hormone group was treated with methylprednisolone on this basis,and the combined group was treated with edar-avone on the basis of the hormone group.The curative effect,Montreal Cognitive Assessment Scale(MoCA)score,Hasegawa Dementia Scale(HDS)score,serum S100B and caspase-3 levels and EEG before and after treatment were compared between the two groups.Re-sults The total effective rate of the combined group was 92.31%,which was obviously higher than that of the hormone group(74.00%)(P<0.05).The inter subject effect test results showed that MoCA,HDS score,serum S100B,and caspase-3 levels before treatment were higher than those one month after treatment;there were significant differences between the two groups in MoCA,HDS score,serum S100B and caspase-3 levels 1 month after treatment(P<0.05).One month after treatment,the EEG in the combined group was obvious-ly better than that in the hormone group(P<0.05).Conclusion Edaravone combined with methylprednisolone has a definite effect on DEACMP patients,which can effectively down-regulate the levels of serum S100B and caspase-3,obviously reduce dementia symptoms and cognitive impairment,and obviously improve EEG.