关键词:

急性一氧化碳中毒迟发性脑病, 危险因素, 高压氧治疗

Abstract:

Objective　To study the risk factors associated with delayed encephalopathy in patients with acute carbon monoxide poisoning (ACOP). Methods　A retrospective analysis was performed on 365 patients with moderate to severe ACOP treated at Inner Mongolia Autonomous Region People's Hospital from October 2020 to October 2023. There were 154 females and 211 males. They were 18-80 years old. Their clinical data were collected. They were followed up for more than 60 days. According to whether delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) occurred, the patients were divided into a DEACMP group (80 cases) and a non-DEACMP group (285 cases). The univariate analysis was used to compare the general clinical data and the first emergency laboratory indicators between the two groups, and the indicators with statistical differences were selected for the multivariate logistic regression analysis to analyze the risk factors of DEACMP. According to their age, the patients were divided into a 18-45 years old group (92 cases), a >45-60 years old group (142 cases), and a >60-80 years old group (131 cases); the clinical data and the first emergency laboratory indicators were compared between the 3 groups. χ² test and Fisher's precision probability test were used to compared the data between the groups. Results　The results of univariate analysis showed that there were statistical differences between the DEACMP group and the non-DEACMP group in age, previous history (diabetes and hypertension), duration of coma, toxicity degree, myocardial injury, rhabdomyolysis, lung infection, and first hyperbaric oxygen therapy (HBOT) time (all P<0.05). The early abnormal rates of white blood cell count (WBC), C-reaction protein (CRP), D-dimer (D-D), troponin I (cTnI), and creatine kinase (CK) in the DEACMP group were higher than those in the non-DEACMP group [73.8% (59/80) vs. 42.8% (122/285), 47.5% (38/80) vs. 27.1% (77/285), 61.3% (49/80) vs. 20.7% (59/285), 67.5% (54/80) vs. 27.7% (79/285), and 78.8% (63/80) vs. 35.1% (100/285)], with statistical differences (all P<0.05). The results of multivariate logistic regression analysis showed that age increase, long duration of coma, myocardial injury, long first HBOT time, and early abnormal CRP, D-D, cTnI, and CK were independent risk factors for DEACMP (all P<0.05). The elder the patients with ACOP were, the longer the duration of coma, the easier to have rhabdomyolysis, the higher the rates of early abnormal CRP and cTnI, and the more likely they had DEACMP. Conclusion　Age increase, long duration of coma, myocardial injury, long first HBOT time, and early abnormal CRP, D-D, cTnI, and CK may be the independent risk factors for DEACMP.

Key words:

Delayed encephalopathy after acute carbon monoxide poisoning, Risk factors, Hyperbaric oxygen therapy