2021 年第 2 期 第 16 卷

地塞米松联合高压氧对一氧化碳中毒迟发性脑病患者神经功能和炎症因子水平的影响

Effects of dexamethasone combined with hyperbaric oxygen on nerve function and inflammatory factors of patients with delayed encephalopathy caused by carbon monoxide poisoning

作者：杨微范新

英文作者：Yang Wei Fan Xin

单位：三二○一医院急诊科，陕西省汉中市723000

英文单位：Department of Emergency 3201 Hospital Shaanxi Province Hanzhong 723000 China

关键词：一氧化碳中毒迟发性脑病；地塞米松；高压氧；神经功能

英文关键词：Delayedencephalopathycausedbycarbonmonoxidepoisoning;Dexamethasone;Hyperbaricoxygen;Neuralfunction

• 摘要：

• 目的 探讨地塞米松联合高压氧对一氧化碳中毒迟发性脑病（DEACMP）患者神经功能和炎症因子水平的影响。方法 选取三二○一医院2018年1月至2019年12月收治的DEACMP患者100例，应用随机数字表法分为对照组和观察组，各50例。对照组给予脱水剂和脑保护药物联合高压氧治疗,观察组在对照组治疗基础上联合地塞米松治疗,2组均连续治疗2个月，对其临床疗效，治疗前后认知功能评分和日常活动能力，治疗前和治疗2、4周后血清白细胞介素6（IL-6）、IL-8、IL-18水平进行比较。结果 治疗2个月后，观察组总有效率高于对照组［92.0%(46/50)比72.0%（36/50）］，2组Barthel指数评分、简易智能精神量表评分和蒙特利尔认知评估量表评分均高于治疗前，且观察组均高于对照组［(87.4±13.5)分比（75.6±9.2）分，(29.5±5.7)分比（27.5±3.2）分，(29±6)分比（25±4）分］（均P<0.05）。治疗2、4周后，2组血清IL-6、IL-8及IL-18水平均低于治疗前，且观察组均低于对照组（均P<0.05）。结论 地塞米松联合高压氧治疗DEACMP，能够改善患者的临床症状，提高日常活动能力和认知功能，抑制炎症因子的表达，有效促进神经功能恢复，提高临床总有效率。

• Objective To investigate the effects of dexamethasone combined with hyperbaric oxygen on neural function and inflammatory factors in patients with delayed encephalopathy caused by carbon monoxide poisoning (DEACMP) . Methods From January 2018 to December 2019， 100 DEACMP patients admitted to 3201 Hospital were selected and randomly divided into control group and observation group, with 50 cases in each group. The control group was treated with dehydrating agent and brain protective drugs combined with hyperbaric oxygen, while the observation group was treated with dexamethasone on the basis of the control group, both group treated for 2 months. The clinical efficacy, cognitive function score and daily activity ability before and after treatment, and the levels of serum interleukin-6 (IL-6), IL-8 and IL-18 before treatment and 2 and 4 weeks after treatment were compared between the two groups.  Results  After 2 months treatment, the total effective rate of the observation group was higher than that of the control group ［92.0%(46/50) vs 72.0%(36/50)］, the Barthel index score, mini mental intelligence scale score and Montreal Cognitive Assessment Scale score in both groups were higher than those before treatment, and the scores in the observation group were higher than those in the control group［(87.4±13.5) vs (75.6±9.2), (29.5±5.7) vs (27.5±3.2), (29±6) vs (25±4)， all P<0.05］. After 2 and 4 weeks of treatment, the levels of serum IL-6, IL-8 and IL-18 in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group (all P<0.05). Conclusion Dexamethasone combined with hyperbaric oxygen therapy for DEACMP, can improve clinical symptoms, improve daily activity and cognitive function, inhibit the expression of inflammatory factors, effectively promote the recovery of neurological function, and improve the total clinical efficiency.