2020 年第 5 期 第 15 卷

醒脑静结合高压氧对一氧化碳中毒患者血清基质金属蛋白酶9和中枢神经特异性蛋白水平及脑功能的影响

Effect of Xingnaojing combined with high pressure oxygen on serum matrix metalloproteinase-9, central nervous specific protein levels and brain function in patients with carbonic oxide poisoning

作者：余毅娟;毛小强;徐小良;吴德军

英文作者：Yu Yijuan Mao Xiaoqiang Xu Xiaoliang Wu Dejun

单位：浙江省衢州市人民医院急诊科324000

英文单位：Department of Emergency Quzhou People′s Hospital Zhejiang Province Quzhou 324000 China

关键词：一氧化碳中毒；醒脑静；高压氧；血清蛋白

英文关键词：Carbonicoxidepoisoning;Xingnaojing;Highpressureoxygen;Serumprotein

• 摘要：

• 目的 探究醒脑静结合高压氧对一氧化碳中毒患者血清基质金属蛋白酶9（MMP-9）、中枢神经特异性蛋白（S100-β）水平和脑功能的影响。方法 选取2017年2月至2018年12月浙江省衢州市人民医院收治的一氧化碳中毒患者90例。按照随机数字表法分为观察组和对照组，各45例。在常规治疗基础上，对照组给予高压氧治疗，观察组给予高压氧+醒脑静治疗，比较2组患者的血清MMP-9、S100-β水平及脑功能相关指标。结果 观察组总有效率高于对照组［91.1%（41/45）比73.3%（33/45）］，差异有统计学意义（χ2=4.865，P=0.027）。治疗后2组MMP-9、S100-β水平均低于治疗前，且观察组低于对照组［（137±38）μg/L比（168±29）μg/L、（0.17±0.03）μg/L比（0.21±0.11）μg/L］，差异均有统计学意义（均P＜0.05）。治疗后观察组迟发性脑病发生率低于对照组，差异有统计学意义（χ2=4.731，P=0.030）。治疗后，2组的美国国立卫生研究院卒中量表与年龄相关性脑白质改变量表评分均低于治疗前，且观察组低于对照组；简易精神状态检查量表评分高于治疗前，且观察组高于对照组，差异均有统计学意义（均P＜0.05）。结论醒脑静结合高压氧治疗能有效改善一氧化碳中毒患者的临床症状，提高治疗有效率，降低患者血清MMP-9、S100-β水平，减少脑组织损伤。

• Objective To explore effect of Xingnaojing combined with high pressure oxygen (HPO) on serum matrix metalloproteinase-9(MMP-9), central nervous specific protein(S100-β) and brain function in patients with carbonic oxide(CO) poisoning. Methods Ninety patients with CO poisoning who were admitted to Quzhou People′s Hospital, Zhejiang Province from February 2017 to December 2018 were enrolled. They were divided into observation group(45 cases) and control group(45 cases). The control group was treated with high pressure oxygen(HPO)and observation group was treated with HPO and Xingnaojing. MMP-9, S100-β and brain function related indexes were compared. Results After treatment, total response rate of observation group was higher than that of control group［91.1%（41/45） vs 73.3%（33/45）］(P＜0.05). After treatment, the levels of serum MMP-9 and S100-βin the two groups were lower than those before treatment［（137±38）μg/L vs （168±29）μg/L, （0.17±0.03）μg/L vs （0.21±0.11）μg/L］ (all P＜0.05). After treatment, the incidence of delayed encephalopathy in the observation group was lower than that in the control group(χ2=4.731，P=0.030). After treatment, scores of National Institutes of Health stroke and age-related white matter changes were lower than those before treatment; scores of mini-mental state examination were higher before treatment (all P＜0.05). ConclusionXingnaojing combined with HPO can effectively improve clinical symptoms of CO poisoning patients, improve response rate of treatment, reduce levels of serum MMP-9 and S100-β and reduce brain tissue damage.