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目的分析一氧化碳中毒迟发性脑病的假愈期长短与年龄、性别、血脂、吸烟、饮酒等因素的相关性,为一氧化碳中毒预后及后续治疗与预防提供参考。方法回顾性分析2011年1月—2016年1月期间延边大学附属医院神经内科就诊的一氧化碳中毒迟发性脑病患者,收集相关人口统计学及临床基本信息,分析上述因素与假愈期长短有相关性,并用美国国立卫生院神经功能缺损评分(National Institutes of Health Stroke scale,NIHSS)进行相关预后分析。结果本研究共有79例一氧化碳中毒迟发性脑病患者完成了60d回顾性随访,按照其假愈期天数长短分为二组,即2~30d组与31~60d组。就二组相关临床资料进行单因素分析可见,在31~60d组中合并糖尿病、高血压、饮酒及嗜烟患者均高于2~30d组,差异有统计学意义(P值均<0.05);31~60d组低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL)及NIHSS评分高于2~30d组,但其高密度脂蛋白胆固醇(High-density lipoprotein cholesterol,HDL)却低于2~30d组,差异有统计学意义(P值均<0.05)。在多因素Logistic回归分析中:校正单因素分析中与一氧化碳中毒迟发性脑病假愈期长短相关的因素(糖尿病、高血压、饮酒、嗜烟、LDL、HDL、NIHSS评分)后,可见糖尿病(OR89.104,95%CI,5.826~13.632)、嗜烟(OR30.510,95%CI,1.832~508.001)是影响一氧化碳中毒迟发性脑病假愈期长短的独立危险因素。结论在一氧化碳中毒发生迟发性脑病患者中,合并糖尿病及嗜烟能够明显延长假愈期时间。
Objective To analyze the correlation between the length of false leave of delayed encephalopathy caused by carbon monoxide poisoning and age, sex, blood lipid, smoking, drinking and so on, so as to provide a reference for the prognosis and follow-up treatment and prevention of carbon monoxide poisoning. Methods Retrospective analysis of patients with delayed encephalopathy of carbon monoxide poisoning admitted to Neurology Department of Affiliated Hospital of Yanbian University from January 2011 to January 2016 collected relevant demographic and clinical basic information and analyzed the above factors correlated with the length of false period The related prognostic analyzes were performed using the National Institutes of Health Stroke Scale (NIHSS). Results A total of 79 patients with delayed encephalopathy after carbon monoxide poisoning were retrospectively reviewed for 60 days. The patients were divided into two groups according to the number of days they were overdone, that is, 2 to 30 days and 31 to 60 days. According to the univariate analysis of the related clinical data of the two groups, the patients with diabetes mellitus, hypertension, alcohol consumption and smoking were higher in the 31 ~ 60d group than those in the 2 ~ 30d group (P <0.05). The low density lipoprotein cholesterol (LDL) and NIHSS score in 31 ~ 60d group were higher than those in 2 ~ 30d group, but the high-density lipoprotein cholesterol (HDL) was lower than that in 2 ~ 30d group , The difference was statistically significant (P <0.05). In the multivariate logistic regression analysis, after adjusting for factors associated with the length of false-onset delayed carbon monoxide poisoning (diabetes, hypertension, alcohol consumption, addicted to smoking, LDL, HDL, NIHSS scores) in univariate analysis, OR89.104, 95% CI, 5.826 ~ 13.632). Tobacco smoke (OR30.510, 95% CI, 1.832 ~ 508.001) was an independent risk factor for the duration of false-onset of delayed encephalopathy after carbon monoxide poisoning. Conclusions In patients with delayed encephalopathy caused by carbon monoxide poisoning, the combination of diabetes mellitus and cigarette smoking can significantly prolong the leave time.