急性一氧化碳中毒后迟发性脑病患者血清SIOOB蛋白、胶质纤维酸性蛋白水平及其临床意义

目的研究急性一氧化碳中毒后迟发性脑病（DEACMP）患者血清S100B蛋白、胶质纤维酸性蛋白（GFAP）水平的动态变化及其临床意义。方法采用酶联免疫吸附法动态测定33例DEACMP患者血清S100B蛋白、GFAP水平，用日常生活能力量表（ADL）、常识-记忆-注意测验（IMCT）、长谷川痴呆量表（HDS）动态检查DEACMP患者病情变化，并与32例急性一氧化碳（CO）中毒后未发生迟发性脑病患者进行比较。结果（1）DEACMP组急性期血清S100B蛋白（0．60±0．21）ng／ml]、GFAP水平（226．58±90．05）ng／ml]明显高于急性CO中毒组分别为（0．50±0．20）ng／ml，（183．04±73．01）ng／ml]和DEACMP组恢复期分别为（0．51±0．16）ng／ml，（183．25±81．76）ng／ml]，差异具有统计学意义（均P〈0．05）。（2）DEACMP组血清S100B蛋白和GFAP水平在急性期和恢复期均有显著相关性（急性期r=0．466，P=0．006；恢复期r=0．365，P=0．037）。（3）DEACMP组急性期血清S100B蛋白、GFAP水平无效组明显高于其他各组（均P〈0．05）。（4）DEACMP组急性期ADL、HDS、IMCT评分分别为（45．21±9．69）分，（8．26±6．31）分，（9．91±7．52）分]号恢复期分别为（33．67±13．62）分，（15．91±10．83）分，（19．06±10．37）分]比较，差异具有统计学意义（均P〈0．01）。结论DEACMP存在二次脑损伤，胶质激活在DEACMP脑损伤中可能起着重要作用；S100B蛋白、GFAP水平可能与预后有关。

Serum SIOOB protein and GFAP levels and their clinical significance in patients with delayed encephalopa- thy after acute carbon monoxide poisoning

Objective To explore the dynamic changes of serum S100B and glial fibrillary acidic protein （GFAP） levels and their clinical significance in patients with delayed encephalopathy after acute carbon monoxide poisoning （DEACMP）. Methods By means of enzyme-linked immunno-sorbent assay （ELISA）, the serum SIOOB and GFAP levels from 33 DEACMP patients were assayed, and the condition changes were analyzed with three types of scale ：the activity of daily living scale （ADL） , information-memory-concentration test （IMCT） and Hasegawa＇ s dementia scale（HDS）. The comparison with 32 patients of acute carbon monoxide poisoning without DEACMP was also conducted. Results （ 1 ） The serum S100B（ （0.60 ± 0.21 ） ng/ml） and GFAP（ （226.58 ± 90.05） ng/ml） in DEACMP group at acute stage were significantly higher than those in acute-CO-poisoning group （ （0.50 ± 0. 20） ng/ml, （ 183.04 ± 73.01 ） ng/nd） and those in DEACMP group at convalescent stage （ （ O. 51 -± 0.16） ng/ml, （ 183.25 ± 81.76） ng/ml） （ all P values 〈 0.05 ）. （2） In DEACMP group, the serum SIOOB and GFAP at acute and convalescent stages were significantly correlated （at acute stage： r = 0. 466, P = 0. 006; at convalescent stage： r= 0.365, P=0. 037）. （3）The S100B and GFAP in ineffective DEACMP patients at acute stage were significantly higher than those in the other groups（ all P values 〈 0.05 ）. （4）In DEACMP group, the ADL, HDS and IMCT scores（ （45.21 ± 9.69）, （8.26 ± 6.31 ）, （9.91 ± 7.52） ） at acute stage were significantly dif- ferent from those at convalescent stages （ （ 33.67 ± 13.62 ）, （ 15.91 ± 10.83 ）, （ 19.06 ± 10.37 ） ） （ all P values 〈 0. 01 ）. Conclusion There is secondary brain insult （SBI） in DEACMP; glial activation may play an important role. The S100B and GFAP levels may be associated with the prognosis of DEACMP.