| ObjectiveSome patients after a certainintermittment period following recovery fromacutecarbon monoxide poisoning(ACMP),damage toentral nervous system based neuropsychiatric symptoms develop rapidly once again,will be called delayed encephalopathy after acute carbon monoxide poisoning(DEACMP),which is a disease that seriously affects the quality of life of patients and is no specific treatment.In this study,the effect of high frequency repetitive transcranial magnetic stimulation(rTMS)on DEACMP and the effect on the level of serum brain derived growth factor(BDNF)was studied,andexplore on the neural repair mechanism of rTMS.Methods:1.Object and groupingAccording to the diagnostic criteria and the criteria of group selection,42 patientswith delayed encephalopathy of carbon monoxide poisoning in Huanggang Central Hospital in September 2014-2016 were randomly divided into rTMS stimulation group and r TMSsham stimulation group.Two groups were given conventional drugs and hyperbaric oxygen therapy.After x2 test and t test,there were no significant difference between the two groups in age,sex ratio,marital status,age of education,and duration of disease(p>0.05).2.TreatmentrTMS stimulation group was given real rTMS stimulation(Study Group);other group was given sham r TMS stimulation(control group).Repetitive transcranial magnetic stimulation therapy method :Transcranial magnetic stimulation instrument produced by Medtronic company,Magpro X100,the use of "8" type coil,the treatment site in the left dorsolateral prefrontal cortex part,stimulus intensity was 110% MT,the stimulus frequency is chosen 10 Hz,once daily for 20 min(30 series of stimulation,each string to stimulate 5S,intermittent s of 30 S,a total of 1500 times),the treatment of the week for 5 times,treatment for 4 weeks,a total of treatment for 20 times.The sham stimulation method is not to open the power supply,other treatment parameters are consistent with the true stimulus.3.Curative effect observation indexThe Barthel index(BI)score andmini-mental state examination(MMSE)score were observed before and after treatment in the rTMS group and the sham stimulation group.4.Specimen collection and detectionmethodsAll the patients in the treatment group before and after treatment were taken from the early morning fasting venous blood 5 m L,3000 r/min,centrifugation 10 min,static.Take the upper layer to clarify the serum,stored in the-68 DEG C incubator ELISA method was used to detect the serum BDNF.All testing steps are strictly in accordance with the instructions,which can sample,sealing plate,water bath,wash the plate,enzyme,color,last read the OD value operation.5.Analysis of datasCount data using x 2 test,and measurement data using t test.paired data using correlation analysis,using SPSS 19 statistical analysis,There are significant difference P<0.05 asinspection standard..Results1 BI score,compared with before treatment and control group,the study groupafter 4 weeks BI score improved significantly(P<0.05).2 MMSE score,compared with before treatment and control group,the studygroup 4 weeks after the MMSE score improved significantly(P<0.01).3 The level of BDNF was significantly higher in the study group than in thecontrol group before and after treatment at 4 weeks(P<0.05).(4)The improvement of MMSE score was positively correlated with the change ofBDNF concentration(OR=0.86,P<0.05).Conclusion(1)rTMS can effectively improve the ability of daily living and cognitive functionin patients with delayed encephalopathy after carbon monoxide poisoning(2)The rTMS can improve the delayed encephalopathy of carbon monoxidepoisoning due to the concentration of serum BDNF,MMSE score improvement waspositivelycorrelated with BDNF concentration,that increased serum BDNFconcentration may be one of the molecular mechanisms of rTMS to improve thecognitive function of delayed encephalopathy of carbon monoxide poisoning.(3)rTMS is a safe and effective method for treatment of delayed encephalopathycaused by carbon monoxide poisoning... |
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