Department of Emergency Medicine, Gazi University School of Medicine, Ankara, Turkey.
Clin Toxicol (Phila). 2012 Jul;50(6):497-502. doi: 10.3109/15563650.2012.698742.
Carbon monoxide (CO) poisoning causes hypoxia that results tissue injury, especially in the brain and heart. Delayed neurologic sequela is one of the most serious complications that may occur up to 40% of severe CO poisoning cases.
The aim of the study was to determine an association between the serum tau protein and severe neurologic symptoms/signs upon presentation.
Seventy-eight patients with CO poisoning were evaluated in this cross-sectional study. The patients were divided into two groups, Group 1: those with loss of consciousness (LOC)/syncope, seizure, coma, altered mental status (n = 19), and Group 2; without LOC (n = 59). Serum tau protein levels were studied on admission.
Mean age of the patients was 37.3 ± 15.4 and 53.6% were male. Headache was the most common presenting symptom observed among 67 patients (86%). The median serum tau protein level was 76.54 pg/mL (35.56-152.65) within group 1, 64.04 pg/mL (23.85-193.64) in patients within group 2 (p = 0.039), respectively. The median serum tau protein levels were 79.80 pg/mL (35.56-193.64) in patients who received HBO therapy and 65.79 pg/mL (23.85-167.29) in patients who did not receive HBO therapy (p = 0.032). The value of area under the curve was 0.642 for detecting CO poisoning with severe neurological symptoms.
Although tau protein levels were significantly higher in patients with severe neurological symptoms; the difference did not reach a clinical significance. Further studies are needed in order to reveal the validity of tau protein for detecting neurological injuries in patients with CO toxicity.
一氧化碳(CO)中毒会导致缺氧,从而导致组织损伤,尤其是在大脑和心脏。迟发性神经后遗症是最严重的并发症之一,可能发生在多达 40%的重度 CO 中毒病例中。
本研究旨在确定入院时血清 tau 蛋白与严重神经症状/体征之间的关系。
本横断面研究评估了 78 例 CO 中毒患者。患者分为两组,第 1 组:意识丧失(LOC)/晕厥、癫痫、昏迷、精神状态改变(n=19),第 2 组:无 LOC(n=59)。入院时检测血清 tau 蛋白水平。
患者的平均年龄为 37.3±15.4 岁,53.6%为男性。头痛是 67 例患者中最常见的首发症状(86%)。第 1 组患者的中位血清 tau 蛋白水平为 76.54pg/ml(35.56-152.65),第 2 组患者为 64.04pg/ml(23.85-193.64)(p=0.039)。接受 HBO 治疗的患者中位血清 tau 蛋白水平为 79.80pg/ml(35.56-193.64),未接受 HBO 治疗的患者为 65.79pg/ml(23.85-167.29)(p=0.032)。曲线下面积(AUC)值为 0.642,用于检测有严重神经症状的 CO 中毒。
尽管重度神经症状患者的 tau 蛋白水平明显升高,但差异无临床意义。需要进一步研究 tau 蛋白在检测 CO 中毒患者神经损伤中的有效性。