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血清生化标志物及表观扩散系数对急性一氧化碳中毒后迟发性脑病的预测价值

Predictive Values of Serum Biochemical Markers and Apparent Diffusion Coefficient on Delayed Encephalopathy After Acute Carbon Monoxide Poisoning.

作者信息

Sun Runming, Cao Wenyuan, Ji Zhangge, Bian Wenwen, Wang LiXia, Wang Qian, Li Zhaodong

机构信息

Zibo Municipal Hospital, Department of Neurology, Zibo City, Shandong Province, China.

出版信息

Turk Neurosurg. 2021;31(6):851-856. doi: 10.5137/1019-5149.JTN.30830-20.2.

Abstract

AIM

To explore the predictive values of serum biochemical markers and apparent diffusion coefficient (ADC) on delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).

MATERIAL AND METHODS

Seventy-nine patients were divided into two groups based on the onset of DEACMP 60 days after with acute carbon monoxide poisoning. The baseline data of ACMP patients were collected. Serum levels of cardiac troponin I (cTNI), lactic acid (Lac), carboxyhemoglobin (COHb), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), C-reactive protein (CRP), and neuron-specific enolase (NSE) were measured within 24 hours of ACMP onset. The ADC of globus pallidum, centrum semiovale, and periventricular white matter were recorded by diffusion-weighted magnetic resonance imaging (DW-MRI) within 48 hours of admission. Logistic regression analysis was performed to determine the risk factors for DEACMP.

RESULTS

The incidence of coma and duration of poisoning in the DEACMP group were significantly higher than those in the non-DEACMP group. The levels of Lac, CK, CK-MB, LDH, CRP and NSE in the DEACMP group were higher than those in the non- DEACMP group. The ADC value of globus pallidus in the DEACMP group was significantly higher than that in non-DEACMP group. The duration of poisoning, coma degree, CK, LDH, NES, and CRP were closely associated with the occurrence of DEACMP.

CONCLUSION

The duration of poisoning, coma degree, and serum levels of CK, LDH, CRP, and NSE were independent risk factors for DEACMP.

摘要

目的

探讨血清生化标志物及表观扩散系数(ADC)对急性一氧化碳中毒后迟发性脑病(DEACMP)的预测价值。

材料与方法

79例患者根据急性一氧化碳中毒后60天内是否发生DEACMP分为两组。收集急性一氧化碳中毒患者的基线数据。在急性一氧化碳中毒发病后24小时内检测血清心肌肌钙蛋白I(cTNI)、乳酸(Lac)、碳氧血红蛋白(COHb)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、C反应蛋白(CRP)和神经元特异性烯醇化酶(NSE)水平。入院后48小时内通过扩散加权磁共振成像(DW-MRI)记录苍白球、半卵圆中心和脑室周围白质的ADC值。进行Logistic回归分析以确定DEACMP的危险因素。

结果

DEACMP组昏迷发生率和中毒持续时间显著高于非DEACMP组。DEACMP组Lac、CK、CK-MB、LDH、CRP和NSE水平高于非DEACMP组。DEACMP组苍白球ADC值显著高于非DEACMP组。中毒持续时间、昏迷程度、CK、LDH、NES和CRP与DEACMP的发生密切相关。

结论

中毒持续时间、昏迷程度以及血清CK、LDH、CRP和NSE水平是DEACMP的独立危险因素。

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