| Objectives 1 To observe the changes of plasma D-dimer,mean platelet volume(MPV)and maximum platelet aggregation rate(MAR%)in patients with acute moderate to severe carbon monoxide poisoning(ACOP)and its clinical significance.2 Analysis of factors affecting prognosis.In turn,the treatment is guided to provide a basis for clinical diagnosis and treatment.Methods 1 Eighty patients with moderate to severe acute carbon monoxide poisoning admitted to Tangshan Workers' Hospital were selected as ACOP group.According to the "Diagnostic Criteria for Occupational Acute Carbon Monoxide Poisoning"(GBZ23-2002),it is divided into moderate poisoning group(38 cases)and severe poisoning group(42 cases)according to the degree of illness;it is divided into delayed encephalopathy according to prognosis.Group and non-late encephalopathy group.Forty healthy subjects in our physical examination center were selected as the control group.Participating researchers performed the informed consent procedures.2All patients in the ACOP group received blood on the fasting day(1d),3d,7d,14 d,21d on the day of admission.The control group took blood on an empty stomach in the morning to detect plasma D-dimer,MPV and MAR%.At the same time,the gender,past history(Hypertension,Diabetes history),Glasgow score at the first visit,the third day of admission,phosphocreatine kinase isoenzyme(CK-MB),and delayed encephalopathy were recorded in detail.Statistical analysis was performed by t test,analysis of variance of repeated measures,and unconditional logistic regression analysis.Results 1 On the day of admission(1d),plasma D-dimer,MPV,and MAR levels were significantly higher in the ACOP group than in the control group(P<0.01).2 The distributions of plasma D-dimer,MPV and MAR in the severe group and the moderate group were different on the 1st,3rd,7th,14 th and 21 st day,and the difference was statistically significant(P<0.05).The above indicators of different degrees of poisoning were also different,the difference was statistically significant(P<0.05),and the severe group D-dimer,MPV,MAR were higher than the moderate group.However,for the above indicators,there was no interaction between time and group(P>0.05).3 On the third day of admission,the plasma D-dimer and MAR levels were higher in theencephalopathy group than in the non-encephalopathy group(P<0.05),but the MPV difference was not significant(P>0.05).4 Unconditional logistic regression analysis showed that MAR,CK-MB,plasma D-dimer and first-time GCS were associated with the onset of delayed encephalopathy on the third day of admission,P < 0.05,which was statistically significant.Conclusions 1 The formation of microthrombus in patients with moderate to severe ACOP supports the "hypoxia and microthrombus theory" in the pathogenesis of DEACMP from a laboratory perspective.And this phenomenon occurs early,the clinical should be intervened as soon as possible.2 D-dimer,MPV,and MAR levels reflect the severity of the disease,and patients with severe poisoning are higher,which can be used as one of the indicators for disease monitoring.3 In the early stage of treatment,the higher the measured value of plasma D-dimer and MAR,the more prone to delayed encephalopathy;the abnormal level of CK-MB and the first diagnosis of GCS ? 8 are also related to the occurrence of encephalopathy.The clinical situation should pay attention to the occurrence of the above situation.Take precautionary measures as soon as possible.Figure three;Table seven;Reference ninety-one... |
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