标题：高压氧联合银杏达莫注射液治疗一氧化碳中毒后迟发性脑病疗效观察

      作者：蔡兆国，张春生    北京怀柔医院高压氧科，北京 101400

      卷次： 2022年33卷22期

      【摘要】 目的 探究高压氧联合银杏达莫注射液对一氧化碳中毒(CMP)后迟发性脑病的临床治疗效果。方法 选取2016年11月至2021年4月北京怀柔医院高压氧科收治的110例CMP后迟发性脑病患者为研究对象，按照随机数表法分为对照组和联合组，每组55例。对照组患者给予高压氧治疗，联合组患者给予高压氧联合银杏达莫注射液治疗，均治疗 14 d。比较两组患者治疗前后的血清胰岛素生长因子-1 (IGF-1)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6 (IL-6)水平、认知功能[蒙特利尔认知评估量表(MoCA)、简易智能精神量表(MMSE)]、脑白质病变[年龄相关性脑白质改变量表(ARWMC)]、血清神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S100β)水平，同时比较两组患者的临床治疗效果。结果 与治疗前比较，两组患者治疗后的血清 IGF-1水平、MoCA评分和MMSE评分均明显升高，且联合组明显高于对照组，差异均有统计学意义(P<0.05)；与治疗前比较，两组患者治疗后的血清TNF-α、IL-6、NSE、S100β水平、ARWMC评分均明显降低，且联合组明显低于对照组，差异均有统计学意义(P<0.05)；联合组患者的治疗总有效率为92.73%，明显高于对照组的76.36%，差异有统计学意义(P<0.05)。结论 高压氧联合银杏达莫注射液治疗CMP后迟发性脑病可有效调节患者的血清 IGF-1、TNF-α、IL-6水平，减轻炎症反应，改善认知功能及神经功能，临床应用效果显著。
      【关键词】 一氧化碳中毒后迟发性脑病；银杏达莫注射液；高压氧；认知功能；神经功能；炎症反应；疗效
      【中图分类号】 R651.1 【文献标识码】 A 【文章编号】 1003—6350（2022）22—2874—04

Clinical efficacy of hyperbaric oxygen combined with Ginkgo-damole injection on delayed encephalopathy aftercarbon monoxide poisoning.
CAI Zhao-guo, ZHANG Chun-sheng. Department of Hyperbaric Oxygen Medicine, BeijingHuairou Hospital, Beijing 101400, CHINA
【Abstract】 Objective To explore the clinical efficacy of hyperbaric oxygen combined with Ginkgo-damole in-jection on delayed encephalopathy after carbon monoxide poisoning (CMP). Methods A total of 110 patients with de-layed encephalopathy after CMP who were admitted to Department of Hyperbaric Oxygen Medicine, Beijing HuairouHospital from November 2016 to April 2021 were selected as the research objects and divided into the control group andthe combined group according to the random number table method, with 55 patients in each group. The patients in thecontrol group were given hyperbaric oxygen therapy, and the patients in the combined group were given hyperbaric oxy-gen combined with Ginkgo-damole injection for 14 days. Serum insulin growth factor-1 (IGF-1), tumor necrosis factorα (TNF-α), and interleukin-6 (IL-6) levels, cognitive function [Montreal Cognitive Assessment Scale (MoCA),Mini-Mental Mental Scale (MMSE)] were compared between the two groups before and after treatment, as well as whitematter lesions [age-related white matter changes scale (ARWMC)], serum neuron-specific enolase (NSE), central ner-vous system-specific protein (S100β) level, and clinical efficacy. Results Compared with before treatment, the serumIGF-1 level, MoCA score, and MMSE score of the two groups after treatment were significantly increased, and theywere significantly higher in the combined group than the control group, with statistically significant difference (P<0.05).Compared with the control group, the serum TNF-α, IL-6, NSE, S100β levels, and ARWMC scores of the two groups af-ter treatment were significantly decreased, and they were significantly lower in the combined group than the controlgroup, with statistically significant differences (P<0.05). The total effective rate of the combined group was 92.73%, sig-nificantly higher than 76.36% of the control group (P<0.05). Conclusion Hyperbaric oxygen combined with Gink-go-damole injection in the treatment of patients with delayed encephalopathy after CMP can effectively regulate serumIGF-1, TNF-α, IL-6 levels, reduce inflammation, improve cognitive and neurological functions, and promote recovery,with significant effects.
      【Key words】 Delayed encephalopathy after carbon monoxide poisoning; Ginkgo-damole injection; Hyperbaricoxygen; Cognitive function; Neurological function; Inflammation; Curative effect