Deschamps D, Géraud C, Julien H, Baud F J, Dally S
Department of Internal Medicine and Clinical Toxicology, Fernand Widal-Lariboisiére Hospital, 75475 Paris Cedex 10, France.
Occup Environ Med. 2003 Mar;60(3):212-6. doi: 10.1136/oem.60.3.212.
Serious delayed neuropsychological sequelae may complicate carbon monoxide intoxication. The existence of minor manifestations, especially memory disturbances, is not well documented.
To study several memory functions after carbon monoxide intoxication.
In a prospective study, 32 poisoned patients without risk factors for cognitive disturbances were compared to 32 paired control subjects one month after acute carbon monoxide intoxication (blood carbon monoxide concentration at least 1.0 mmol/l), who had been treated with standard conventional therapy. Psychometric tests included Buschke's verbal memory testing, verbal digit span, Corsi's visuospatial span, reaction times, Stroop's colours decoding test, and verbal fluency test.
(1) Memory functions in poisoned subjects were not worse than in the control group and were even better in some areas: learning, word recall, and quality of learning by Buschke's verbal memory testing. Attention was also better in the patients, in whom visual reaction time was shorter than in controls. (2) Results of several memory functions-quality of learning and immediate visual memory-were positively correlated with the initial carbon monoxide level.
In a highly selected subset of patients devoid of risk factors for memory impairment, memory, objectively evaluated by psychometric testing, was not worse one month after carbon monoxide intoxication in patients undergoing standard treatment than in paired control subjects.
严重的迟发性神经心理学后遗症可能使一氧化碳中毒复杂化。轻微表现尤其是记忆障碍的存在情况,文献记载并不充分。
研究一氧化碳中毒后的几种记忆功能。
在一项前瞻性研究中,将32例无认知障碍风险因素的中毒患者与32例配对的对照者进行比较,这些对照者在急性一氧化碳中毒(血中一氧化碳浓度至少1.0 mmol/l)一个月后接受了标准常规治疗。心理测量测试包括布施克言语记忆测试、言语数字广度、科尔西视觉空间广度、反应时间、斯特鲁普颜色解码测试和言语流畅性测试。
(1)中毒患者的记忆功能并不比对照组差,在某些方面甚至更好:布施克言语记忆测试中的学习、单词回忆和学习质量。患者的注意力也更好,其视觉反应时间比对照组短。(2)几种记忆功能的结果——学习质量和即时视觉记忆——与初始一氧化碳水平呈正相关。
在一个经过高度筛选、无记忆损害风险因素的患者亚组中,通过心理测量测试客观评估发现,接受标准治疗的患者在一氧化碳中毒一个月后的记忆情况并不比配对的对照者差。