目的 探讨急性一氧化碳中毒后迟发性脑病(delayed encephalopathy after acute carbon monoxide poisoning,DEACM P)患者脑脊液中S100β、Jun氨基末端激酶(jun amino-terminal kinase,JNK)通路蛋白、白细胞介素-4(interleukin-4,IL-4)、IL-10、转化生长因子β1(transforming growth factor β1,TGF-β1)及干扰素γ(inter-feron-γ,IFN-γ)的变化及其临床意义.方法 选取2010-01—2016-12作者医院收治的DEACM P 患者20例(DEACM P组),另收集同期发生一氧化碳中毒但未发生迟发性脑病的患者37例作为对照组,检测两组患者入院后第2天脑脊液中S100β、JNK 通路蛋白(JNK1、JNK2)及TNF-ɑ、IL-4、IL-10、TGF-β1、IFN-γ水平,并于治疗2周后对两组患者进行简易精神状态量表(mini-mental state examination,MMSE)评分,分析脑脊液S100β蛋白、JNK通路蛋白及相关细胞因子与 MMSE评分的相关性.结果 DEACMP组脑脊液中S100β、JNK1、JNK2、TNF-ɑ、IFN-γ水平均高于对照组(P< 0.05),而 IL-4、IL-10、TGF-β1水平及 MMSE评分均低于对照组(P<0.05).DEACMP组患者MMSE评分与患者脑脊液中S100β、JNK1、JNK2、TNF-ɑ、IFN-γ水平呈负相关(P<0.05),与IL-4、IL-10、TGF-β1水平呈正相关(P<0.05).结论 DEACMP患者脑脊液中S100β、JNK 通路蛋白及相关细胞因子发生明显改变,且其水平与患者恢复期认知功能损害有关.%Objective To explore the changes and its clinical significance of cerebrospinal fluid S100 beta,JNK pathway proteins and interleukin -4(IL-4),IL-10,transforming growth factor beta 1(TGF-beta 1)and interferon gamma(IFN-γ)in delayed encephalopathy after acute carbon monoxide intoxication (DEACMP)patients.Methods Twenty patients with DEACMP who were admitted to our hospital from January 2010 to December 2016 were enrolled in this study.Thirty-seven patients who had carbon monoxide poisoning but without delayed encephalopathy were selected as the control group during the same period.The levels of S100β, JNK pathway proteins(JNK1,JNK2)and TNF-ɑ,IL-4,IL-10,TGF-β1 and IFN-γ in cerebrospinal fluid were measured.After two weeks of treatment,the MMSE scores of the two groups were tested,and the correlations between MMSE score and S100B protein, JNK pathway proteins, related cytokines were analyzed.Results Compared with the control group,the levels of S100β,JNK1,JNK2,TNF-ɑ and IFN-γ in the DEACMP group significantly increased(P<0.05),while the levels of IL-4,IL-10 and TGF-β1 significantly decreased(P<0.05).The MMSE score in the DEACMP group was negatively correlated with the levels of S 100β, JNK1,JNK2,TNF-ɑ and IFN-γ,and positively correlated with the levels of IL-4,IL-10 and TGF-β1(P<0.05). Conclusions The S100 beta,JNK pathway protein and related cytokines in the cerebrospinal fluid of DEACMP patients are significantly altered and related to the cognitive impairment in the patients'recovery period.
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