Kim Hyuk-Hoon, Choi Sang Chun, Chae Minjung Kathy, Min Young-Gi
Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
Medicine (Baltimore). 2018 Jan;97(1):e9569. doi: 10.1097/MD.0000000000009569.
In acute carbon monoxide (CO) intoxication, treatment of neurologic injury and prevention of neurological sequelae are primary concerns. Ethanol is the one of the frequent substances which is co-ingested in intentional CO poisoning. Neuroprotective effect of ethanol was highlighted and demonstrated in isolated brain injury recently. We assessed the neuroprotective effect of ethanol in acute CO intoxication using magnetic resonance imaging (MRI).We retrospectively reviewed medical records for patients who visited an emergency medical center of a university-affiliated hospital during a period of 73 months, from March 2009 to April 2015. Enrolled patients were divided into 2 groups, patients with or without abnormal brain lesion in brain MRI. Multivariate logistic regression analysis was performed to assess the factors associated with brain injury in MRI.A total of 109 patients with acute CO intoxication were evaluated of which 66 (60.55%) tested positive in brain MRI. MRI lesion-positive patients were more likely to have electrocardiogram change, elevation of serum troponin I and s100 protein level and lower serum ethanol level. Serum ethanol positivity was an independent factor for prevalence of brain injury in MRI in acute CO poisoning.This study revealed that ethanol which is co-ingested in acute CO intoxication may work the neuroprotective effect and could consequence more favorable neurological outcome in acute CO intoxication.
在急性一氧化碳(CO)中毒中,神经损伤的治疗和神经后遗症的预防是主要关注点。乙醇是在故意CO中毒时经常共同摄入的物质之一。最近在离体脑损伤中突出并证明了乙醇的神经保护作用。我们使用磁共振成像(MRI)评估了乙醇在急性CO中毒中的神经保护作用。
我们回顾性分析了2009年3月至2015年4月期间73个月内就诊于某大学附属医院急诊中心的患者的病历。入选患者分为两组,即脑MRI有或无异常脑病变的患者。进行多变量逻辑回归分析以评估与MRI脑损伤相关的因素。
共评估了109例急性CO中毒患者,其中66例(60.55%)脑MRI检查呈阳性。MRI病变阳性患者更有可能出现心电图改变、血清肌钙蛋白I和s100蛋白水平升高以及血清乙醇水平降低。血清乙醇阳性是急性CO中毒患者MRI脑损伤患病率的独立因素。
本研究表明,急性CO中毒时共同摄入的乙醇可能具有神经保护作用,并可能导致急性CO中毒患者获得更有利的神经学结局。