| Objective:To explore the clinical predictive value of serum nerve damage markers (MBP、NSE、S100B protein) and multifunctional magnetic resonance imaging (DWI、1H-MRS) inpatients with delayed encephalopathy after carbon monoxide poisoning.Methods:60cases of carbon monoxide poisoning patients and20cases of healthy volunteers wereenrolled in this study.1. The serum MBP, NSE, S100B protein were measured in all cases. Analyzed thechange of serum MBP, NSE and S100B protein in group of DEACMP、recovery andnormal control in different periods.2. DWI and1H-MRS were performed in60ACOP patients and20healthy volunteers.The ADC values and the ratio of the peak of each organic compound was measured ineach regions of interest. Analyze the change of DWI signals, ADC values，NAA/Cr,Cho/Cr in group of DEACMP、recovery and normal control in different periods.Conduct statistical analysis through statistical package for social science16.0;Using T testand analysis of variance to compare if there was a difference in group of DEACMP、recovery and normal control.Results:1. The content of serum MBP, NSE and S100B protein in period of acute poisoning: The content of NSE, S100B protein in DEACMP group was significantly higher thanthe group of recovery and normal control, and there emerged a profound difference (P<0.01); there was no statistically significant difference between the group ofrecovery and normal control (P>0.05); The content of MBP was the most obviousdifference in three groups (P <0.01).2. The serum MBP, NSE and S100B protein of DEACMP in acute poisoning anddelayed encephalopathy:The content of MBP in delayed encephalopathy was higher than its acute poisoning,and there emerged a profound difference (P <0.01); Compared with acute poisoning,the content of S100B protein and NSE in delayed encephalopathy had no statisticaldifference (P>0.05).3. The serum MBP, NSE and S100B protein of DEACMP in delayed encephalopathyand recovery period:The content of serum MBP, NSE and S100B protein in recovery period was lowerthan its delayed encephalopathy, and there emerged a profound difference (P <0.01).4. DWI and1H-MRS examination:All patients in basal ganglia, centrum semiovale and ventricle narrator mass wereshowed as DWI high signal;1H-MRS showed that NAA peak decline, Cho peakincreases in basal ganglia and ventricle narrator mass. However the above changes inpatients with DEACMP were more apparent.5. The average ADC values at corresponding brain regions in acute poisoning:Healing group was lower than the normal control group. DEACMP group was lowerthan the healing group and normal control group. And there emerged a profounddifference (P <0.01).6. The ADC values in each part of the group of patients with DEACMP group andhealing group: There emerged a profound difference between two groups of patients in each grouppart(P <0.01);Besides, there was no statistically significant difference betweencentrum semiovale and ventricle narrator mass （P＞0.05）, but there emerged aprofound difference of the rest(P <0.01).7. The average ADC values of DEACMP in acute poisoning and delayed encephalopathy:The average ADC values in delayed encephalopathy was lower than its acutepoisoning, and there was statistically difference (P <0.05).8. The NAA/Cr, Cho/Cr at corresponding brain regions in acute poisoning:Compared with normal control group, the NAA/Cr decreased and the Cho/Crincreased in all patients, especially in the DEACMP group. And there emerged aprofound difference (P <0.01).9. The NAA/Cr, Cho/Cr at corresponding brain regions of DEACMP group in acutepoisoning and delayed encephalopathy:There was no statistically significant difference in NAA/C（rP＞0.05）,but the Cho/Crin delayed encephalopathy was higher than its acute poisoning. And there emerged aprofound difference (P <0.01).10. The difference of1H-MRS measurement indexs in each part of the group ofDEACMP, recovery and normal control:There was no obvious difference in group of DEACMP, recovery and normal control（P＞0.05）.Conclusion:1. All patients’ content of serum NSE, S100B protein and MBP were higher than normalcontrol group in acute poisoning;2. Speculated that continuous monitoring the changes of serum MBP content may bemore meaningful to predict the occurrence of DEACMP, but it remains to be furthervalidated. 3. All patients’ ADC values were lower than normal control group in acute poisoning;but basal ganglia was more sensitive to centrum semiovale and ventricle narratormass.4. All patients’ NAA/Cr ratio in different brain regions were lower than normal controlgroup, and Cho/Cr ratio were higher than normal control group; And there was noobvious difference between basal ganglia and ventricle narrator mass. Speculated thatwe could choose basal ganglia or ventricle narrator mass in the clinical to measure. |
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