急性一氧化碳中毒后迟发性脑病患者血清胰岛素样生长因子-1水平及其临床意义研究

摘要

Objective To investigate the dynamic changes of level of serum insulin - like growth factor - 1 ( IGF - 1 ) and its clinical significance in patients with delayed encephalopathy after acute carbon monoxide poisoning ( DEACMP ). Methods 33 DEACMP patients were selected form November 2007 to Jun 2008, IGF - 1 level was assayed with enzyme - linked im-munno - sorbent assay ( ELISA ). Their condition changes were evaluated with Activity of Daily Living Scale ( ADL ), Information - Memory - Concentration Test ( IMCT ) and Hasegawa's Dementia Scale ( HDS ). The above indexes were compared with those of 32 acute carbon monoxide poisoning ( ACMP ) patients without occurrence of DEACMP ( ACMP group ) and of 32 healthy subjects ( control group ). Results ( 1 ) IGF - 1 at acute stage was significantly lower in DEACMP group [ ( 136. 10 ±51. 51 ) μg/L ] than in control group [ ( 192. 91 ± 145. 97 ) μg/L, P < 0. 05 ], there was no significant difference in IGF - 1 at acute stage between groups DEACMP and ACMP [ ( 156. 51 ± 93. 13 ) μg/L ], between groups ACMP and control ( P >0. 05 ). IGF - 1 was higher at recovery stage [ ( 187. 69 ±92. 46 ) μg/L ] than at acute stage in DEACMP group, the difference was significant (P <0. 05 ). (2) ADL, HDS, IMCT at acute stage was significantly different from those at recovery stage in DEACMP group ( P < 0. 05 ). ( 3 ) IGF - 1 was negatively correlated with ADL in DEACMP group ( r = - 0. 377 , P = 0. 03 ). Conclusion IGF - 1, protecting probably DEACMP patients from brain damage, may be used as one of indexes for clinical outcomes and therapeutic effectiveness assessment.%目的 研究急性一氧化碳中毒后迟发性脑病(DEACMP)患者血清胰岛素样生长因子-1(IGF-1)水平的动态变化及其临床意义.方法 选择2007年11月-2008年6月在我院住院的33例DEACMP患者,采用酶联免疫吸附法动态测定血清IGF-1水平,用日常生活能力量表(ADL)、长谷川痴呆量表(HDS)、常识-记忆-注意测验(IMCT)动态评估DEACMP患者的病情变化,并与32例急性一氧化碳中毒(ACMP)后未发生DEACMP的患者(ACMP组)和32例健康体检者(正常对照组)的以上指标进行比较.结果 (1)DEACMP组急性期血清IGF-1水平[(136.10± 51.51)μg/L]低于正常对照组[(192.91±145.97)μg/L,P＜0.05],DEACMP组急性期与ACMP组[(156.51± 93.13)μg/L]比较,ACMP组与正常对照组比较,差异均无统计学意义(P＞0.05).DEACMP组恢复期血清IGF-1水平[(187.69±92.46)μg/L]较急性期升高,差异有统计学意义(P＜0.05).(2)DEACMP组急性期ADL、HDS和IMCT评分与恢复期比较,差异均有统计学意义(P＜0.05).(3)DEACMP组中IGF-1水平与ADL评分呈负相关(r=-0.377,P=0.03).结论 IGF-1在DEACMP脑损伤中可能起着重要保护作用,血清IGF-1水平可能作为临床转归、疗效判定的指标之一.