| ObjectivePart I To investigate the levels and clinical significances of IL-6,IL-8 and IL-18 in the serum in the patients of delayed encephalopathy after carbon monoxide poisoning(DEACMP).And to investigate the changes of these cytokines in DEACMP patients who after treated.Then analyze the correlation between DEACMP and neuroimmunology.Part II To analyze the clinical efficacy of dexamethasone combined with hyperbaric oxygen therapy in DEACMP.MethodsPart I All objects from 94 th hospital of the People's Liberation Army of China from November 2016 to February 2018.We detected the levels of IL-6,IL-8and IL-18 in healthy control group,ACMP,DEACMP,effective and ineffective group of DEACMP after treated by ELISA.Part II Dividing 112 cases of DEACMP patients into observation group(60 cases)and control group(52 cases).All objects from the same hospital from November 2010 to January 2018.The control group was offered hyperbaric oxygen and other basic treatments.The observation group was treated with dexamethasone on the basis of the control group;Statistical analysis the total efficiency,eeg,cranial magnetic resonance examination and MMSE of two groups after therapy.ResultsPart I 1.The levels of IL-6 in ACMP group(29.59±10.15 pg/ml)and DEACMP group(38.39±10.94 pg/ml)were increased than this in healthy control group(24.53±3.39 pg/ml),and DEACMP group was increased obviously than this in ACMP group,the above differences were statistically significant(P<0.05);the level of IL-6 in effective group of DEACMP(25.93±4.13 pg/ml)was decline markedly,but the falling level of IL-6 in ineffective group(36.87±4.03 pg/ml)was unapparent,it has not statistically significant compared with the DEACMP group(P?0.05).2.The levels of IL-8 in ACMP group(100.43±43.79 pg/ml)and DEACMP group(98.54±24.48 pg/ml)were increased than this in healthy control group(55.86±14.79 pg/ml),the differences was statistically significant(P<0.05),however,there was no statistical difference between the ACMP group and DEACMP group(P?0.05);the level of IL-8 in effective group of DEACMP(72.10±17.24 pg/ml)was decline markedly than the ACMP group,the difference was statistically significant(P<0.05).3.The levels of IL-18 in ACMP group(252.87±90.45 pg/ml)and DEACMP group(323.52±70.44 pg/ml)were increased than this in healthy control group(190.47±40.21 pg/ml),and DEACMP group was higher obviously than ACMP group,the above differences were statistically significant(P<0.05);the level of IL-18 in effective group of DEACMP(222.34±92.03 pg/ml)was decline markedly than this in ACMP group,the difference was statistically significant(P<0.05).Part IIThe symptoms of the two groups were improved than before,the improvement rate(RIS)in total efficiency,eeg,MRI of observation group were 85.00%?88.33%?86.67% respectively,the control group were 67.31%,55.77%,63.46% respectively,the differences were statistically significant(P<0.05).The MMSE scores of the observation group and control group before and after treatment were(11.35±2.23),(11.48±2.08)and(26.37±2.95),(20.65±2.31)respectively.All differences were statistically significant between two groups(P<0.05).Conclusions Part I The levels of IL-6?IL-8 and IL-18 in ACMP and DEACMP were increased than those in healthy control group,and DEACMP was increased obviously than ACMP,Then the levels of these cytokines were declined obviously after effective treatment,It suggested that the occurrence of DEACMP was related with neuroimmune injury mechanism.Part II The treatment of dexamethasone combined with hyperbaric oxygen can improve the efficacy of DEACMP patients,but it is necessary to pay attention to its adverse reactions,and the dose and the course of the treatment of hormone should be further discussed. |
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