Effect of hyperbaric oxygen combined with citicoline on acute CO poisoning
Objective To explore the clinical therapeutic effect of hyperbaric oxygen combined with citicoline in acute carbon monoxide(CO)poisoning from the perspectives of brain function and pathogenic mechanism.Methods One hundred and twenty patients with acute carbon monoxide poisoning hospitalized in Hengshui City's Hospital from January 2020 to January 2023 were collected.The patients were randomly divided into control group and observation group,60 cases in each.The patients in control group were treated with hyper-baric oxygen on the basis of routine treatment.The observation group was treated with intravenous drip of citicoline sodium on the basis of control group.The clinical efficacy was evaluated according to the clinical symptoms and physical signs of the patients.The awakening time of the patients in two groups was recorded.Acute Physiology and Chronic Health(APACHE Ⅱ)scores,Montreal Cognitive Assessment Scale(Mo-CA),and Barthel Score were used to assess the patients'prognosis,cognitive function and autonomy of daily living,respectively.Easy Ⅲ electroencephalograph was used to detect the patients'brain functional state in-dexes.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum S100β,specific enolase(NSE),nuclear factor erythroid 2-related factor 2(Nrf2),and heme oxygenase-1(HO-1)in pa-tients.Results The total effective rate of treatment in observation group was 95.00％,significantly higher than that in control group,which was 80.00％(x2=4.876,P=0.027).The awakening time of observation group was significantly lower than that of control group(P＜0.05).After treatment,the levels of APACHEⅡ score,CK-MB,NT-proBNP,cTnI,TNF-α,IL-6,MDA,S100β and NSE were decreased in both groups,while the levels of MoCA score and Barthel score,SOD,Nrf2 and HO-1 were significantly increased(P＜0.05).After treatment,observation group APACHE Ⅱ score,serum levels of NT-proBNP,CK-MB,cTnI,TNF-α,IL-6,MDA,S100β and NSE were significantly lower than those of control group,while MoCA score and Barthel score and serum SOD,Nrf2 and HO-1 protein levels were significantly higher than those of con-trol group(P＜0.05).After 3 months of follow-up,the incidence of delayed encephalopathy in observation group was 3.23％lower than that in control group,and the difference was statistically significant(X2=4.342,P=0.037).Conclusion The clinical effect of hyperbaric oxygen combined with citicoline in treating patients with acute CO poisoning was obvious,significantly improving the patients'brain damage,cognitive function and antioxidant capacity,which may be realized by activating the Nrf2/HO-1 antioxidant pathway.
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