Clinical significance of 5-HT and DA levels in serum and cerebrospinal fluid of the patients with delayed encephalopathy after acute carbon monoxide poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the changes and the clinical significance of 5-hydroxytryptamine (5-HT), dopamine (DA) levels in serum and cerebrospinal fluid (CSF) of patients with delayed encephalopathy (DEACMP) after acute carbon monoxide poisoning.</p><p><b>METHODS</b>The dynamic detection of 5-HT and DA levels in serum and CSF from 42 patients with DEACMP was performed with high performance liquid chromatography (HPLC). The condition changes of patients with DEACMP were analyzed with three types of scales: the activity of daily living scale (ADL), information memory concentration test (IMCT) and Hasegawa's dementia scale (HDS); these changes were compared with those from 38 other encephalopathy patients and 38 non-encephalopathy patients, respectively.</p><p><b>RESULTS</b>Before treatment, the serum 5-HT and DA levels [(662.61 ± 178.50) and (155.74 ± 60.32) nmol/L, respectively] of DEACMP group were both significantly lower than those [(914.08 ± 198.04) and (225.70 ± 48.53) nmol/L] of non-encephalopathy group (P < 0.05); the serum DA level of DEACMP group was also significantly lower than that [(243.57 ± 66.94) nmol/L] of other encephalopathy group (P < 0.05); the serum 5-HT level of DEACMP group was not significantly different from that [(729.54 ± 299.87) nmol/L] of other encephalopathy group (P > 0.05). After treatment, the serum 5-HT and DA levels [(714.08 ± 170.47) and (192.18 ± 33.07 nmol/L, respectively)] of DEACMP group elevated to various extent, but only serum DA level was significantly higher than that before treatment (P < 0.05). Before treatment, the CSF 5-HT and DA levels of DEACMP group were significantly lower than those of non-encephalopathy group and those of other encephalopathy group (P < 0.05). After treatment, the CSF 5-HT level (232.44 ± 54.28 nmol/L) was similar to normal level and significantly higher than that before treatment (P < 0.05); the CSF DA level [(56.83 ± 12.85) nmol/L] of DEACMP group increased only slightly (P > 0.05). In DEACMP group, ADL score (50.64 ± 7.23), HDS score (8.55 ± 8.08) and IMCT score (4.95 ± 7.30) before treatment were significantly different from those (8.5 ± 8.08, 4.95 ± 7.30 and 15.64 ± 10.90) after treatment (P < 0.01). In DEACMP group, there wasa negative correlation between DA level changes and HDS score changes, when the DA levels and HDS scores before treatment were compared with those after treatment (P < 0.05).</p><p><b>CONCLUSION</b>The dynamic changes of 5-HT and DA levels in serum and CSF of patients with DEACMP consisted basically with the patient's condition change. The dynamically detected 5-HT and DA levels can be used as the biological indicators to reflect the condition change and treatment effects of DEACMP patients.</p>

Serum levels of endothelin-1, tumor necrosis factor-α and its clinical significance in patients with delayed encephalopathy after acute carbon monoxide poisoning / 中华神经医学杂志

Objective To investigate the serum levels of endothelin-1 (ET-1), tumor necrosis factor- α (TNF-α) and their dynamic changes in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and their relation with the condition variation of the patients.Methods The serum ET-1 and TNF-α levels were determined with enzyme-linked immunno-sorbent assay (ELISA) in 31 patients with DEACMP, and the dynamic changes of patients' condition were monitored by use of the activity of daily living (ADL) scale, the information-memory-concentration test (IMCT) and the Hasegawa's dementia scale (HDS). The comparisons between patients with DEACMP and both 30 patients with acute carbon momoxide poisoning (ACMP) but without DEACMP and 30 normal controls were also conducted. Results At the acute stage of the DEACMP group, the serum levels of ET-1 and TNF-α were both significantly higher than those in the normal control group (P＜0.05); that of TNF-α was significantly lower than that in the ACMP group (P＜0.05), but that of ET-1 was not significantly different from that in the ACMP group (P＞0.05). The serum levels of ET-1 and TNF- α in the ACMP group were both significantly higher than those in the normal control group(P＜0.05). In the DEACMP group, the serum level of ET-1 at the convalescent stage was significantly lower than that at the acute stage (P＜0.05), but the serum level of TNF-α was not significantly different from that at the acute stage (P＞0.05). At the acute stage of the DEACMP group, ADL scores were significantly higher than those in norms, and IMCT scores and HDS scores were significantly lower than those in norms (P＜0.05). In the DEACMP group, the ADL scores at the convalescent stage were significantly lower than those at the acute stage (P＜0.05), IMCT scores and HDS scores were significantly higher than those at the acute stage (P＜0.05). Significant correlations between scores of any 2 of 3 scales in patients with DEACMP at both acute and convalescent stage were noted (P＜0.05). Conclusion The dynamic detection of serum ET-1 and TNF-α level variations could be used as an indicator for condition severity in patients with DEACMP.