Department of Emergency Medicine, Ataturk University, Medical School, 25090 Erzurum, Turkey.
Am J Emerg Med. 2010 Jan;28(1):61-7. doi: 10.1016/j.ajem.2008.10.032.
Carbon monoxide (CO) toxicity may cause persistent injuries in tissues sensitive to hypoxia. Neuropsychiatric sequelae may be observed in about 67% of cases after severe CO exposure.
The aims of this study were to demonstrate the usefulness of S-100beta and neuron-specific enolase (NSE) in CO intoxications, show the degree of neurological response, and determine the indications for hyperbaric oxygen treatment (HBOT) as biochemical markers.
The S-100beta and NSE levels of the sera of 30 patients were studied upon admittance and at the third and sixth hours. S-100beta levels were found to be high in all 3 analyses. There was no significant change in NSE levels. When the S-100beta levels were compared with Glasgow Coma Scale levels, a strong negative correlation was found for all hours (r = -0.7, -0.8; P = .00). The correlation between S-100beta and carboxyhemoglobin levels at the initial hour was found to be statistically significant (r = 0.4; P = .01). The S-100beta levels in patients receiving HBOT showed a considerable decrease compared with those in patients not receiving the treatment. The same decrease was valid for NSE, although it was insignificant.
S-100beta may be useful in evaluating intoxications as an early biochemical marker in CO intoxications, as well as in the differential diagnosis due to other causes, and in determining HBOT indications.
一氧化碳(CO)中毒可能会导致对缺氧敏感的组织持续损伤。大约 67%的重度 CO 暴露患者会出现神经精神后遗症。
本研究旨在证明 S-100β和神经元特异性烯醇化酶(NSE)在 CO 中毒中的作用,显示神经反应程度,并确定高压氧治疗(HBOT)的适应证作为生化标志物。
对 30 名患者入院时及第 3 小时和第 6 小时的血清 S-100β和 NSE 水平进行了研究。所有 3 次分析均发现 S-100β水平升高。NSE 水平无显著变化。当 S-100β水平与格拉斯哥昏迷量表水平进行比较时,所有时间点均存在强烈的负相关(r = -0.7,-0.8;P =.00)。初始时 S-100β与碳氧血红蛋白水平之间的相关性具有统计学意义(r = 0.4;P =.01)。与未接受 HBOT 治疗的患者相比,接受 HBOT 治疗的患者的 S-100β水平明显下降。NSE 也出现了同样的下降,但无统计学意义。
S-100β可能有助于评估中毒情况,作为 CO 中毒的早期生化标志物,也有助于与其他原因引起的中毒进行鉴别诊断,并确定 HBOT 的适应证。