Effects of Mild Hypothermia Combined with Hyperbaric Oxygen on Myocardial Injury Markers,Oxidative Stress Response and Neurofactors Levels in Patients with Acute Carbon Monoxide Poisoning
Objective:To investigate the effects of mild hypothermia combined with hyperbaric oxygen on myocardial injury markers,oxidative stress response and neurofactors levels in patients with acute carbon monoxide poisoning(ACMP),so as to provide clinical guidance for the treatment of ACMP.Methods:A total of 96 ACMP patients admitted to our hospital from January 2022 to May 2023 were selected and divided into study group(n=48)and control group(n=48)by random number table method.The control group was given hyperbaric oxygen therapy,and the study group was given mild hypothermia combined hyperbaric oxygen therapy.Myocardial injury markers,oxidative stress,neurofactors,neurological function,coma degree,ability of daily living,mortality,incidence of acute car-bon monoxide poisoning delayed encephalopathy(DEACMP)and adverse reactions were compared between the two groups.Results:After treatment,the levels of brain natriuretic peptide(BNP),creatine kinase isoenzyme(CK-MB)and creatine kinase isoenzyme(cTnI)in two groups were decreased(P＜0.05),and the levels in the study group were lower than those in the control group(P＜0.05).After treat-ment,the levels of glutathione peroxidase enzyme(GSH-Px)and superoxide dismutase(SOD)in the two groups were increased(P＜0.05),while the levels of malondialdehyde(MDA)and nitric oxide(NO)were decreased(P＜0.05).The levels of GSH-Px and SOD in the study group were higher than those in the control group(P＜0.05),and the levels of MDA and NO were lower(P＜0.05).After treatment,serum neuron specific enolase(NSE),myelin basic protein(MBP)and cerebrospinal fluid central nerve specific protein(S100β)were decreased in both groups(P＜0.05),and those in the study group were lower than those in the control group(P＜0.05).After treatment,the score of National Institutes of Health Stroke Scale(NIHSS)decreased(P＜0.05),while the score of Glasgow Coma Scale(GCS)and Barthel(BI)of standard daily living ability increased(P＜0.05).The NIHSS score of the study group was lower than that of the control group(P＜0.05),and the scores of GCS and BI were higher(P＜0.05).Mortality and incidence of DEACMP in the study group were 2.08％(1/48)and 16.67％(8/48),which were lower than 10.42％(5/48)and 27.08％(13/48)in the control group(P＜0.05).The incidence of adverse reac-tions in the study group was 12.50％(6/48),which had no statistical significance compared with 18.75％(9/48)in the control group(P＞0.05).Conclusion:The application of mild hypothermia combined with hyperbaric oxygen in the treatment of ACMP patients can reduce the degree of myocardial and nerve damage and coma,relieve the oxidative stress reaction,promote the recovery of nerve function,im-prove the ability of daily living,reduce the mortality and the incidence of DEACMP,with high safety.
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