| Background: acute carbon monoxide poisoning is the highest in the world of occupational poisoning, but carbon monoxide poisoning is not only in the work of occupational poisoning, in daily life, the probability of carbon monoxide poisoning is also higher. Especially in the countryside in the north of China, due to the winter weather is cold, charcoal heating, due to the low temperature in winter outdoor, charcoal often doors and windows closed,resulting in carbon due to the lack of oxygen and can not be completely burned, and produce carbon monoxide gas. The concentration of carbon monoxide gas in a closed room is more and more, which will eventually lead to human inhalation poisoning. It is not clear that the mechanism of carbon monoxide poisoning is still not clear. The mechanism of carbon monoxide poisoning is mainly treated by hyperbaric oxygen therapy and brain tissue repair. It is usually more than one month. Nicotinic acid is a water-soluble vitamin, has a strong role in the expansion of blood vessels, after carbon monoxide poisoning patients with cerebral vascular circulation will have some understanding of the brain will be in the state of ischemia and hypoxia, in theory, the effect of nicotinic acid on its circulation, this study is based on the application value of this acute setting, and the seriousness of the carbon monoxide poisoning.Objective: To evaluate the clinical efficacy of different doses of nicotinic acid(SOD) and malondialdehyde(MDA) in the treatment of acute severe carbon monoxide poisoning, and to study the preventive and therapeutic effects of different doses of nicotinic acid on acute severe carbon monoxide poisoning.Methods: 160 cases of acute severe carbon monoxide poisoning patients admitted to our department during the period of 2013-2015 were studied.Blood SOD and MDA were measured in all patients on the day of admission. The study subjects were divided into four groups. The control group was treated with hyperbaric oxygen therapy combined with conventional treatment and symptomatic treatment. The treatment group was treated with different doses of nicotinic acid(200mg, 600 mg, 400mg) for 7days, 14 days, 21 days. We compared the difference between the four groups of patients in the treatment effect, treatment costs, hospitalization time.Using pyrogallol autoxidation assay(by xanthine oxidase chemiluminescence method for the determination of the activity of superoxide dismutase(SOD),with TBA assay(determination), MDA by thiobarbituric fluorescence method,kit were from Nanjing built biological engineering research are provided.Using statistical data analysis software SPSS21.0 to carry out data analysis,Results:1 The different concentrations of niacin therapy for severe acute carbon monoxide poisoning clinical curative effect1.1 Effect of different concentrations of nicotinic acid treatment group on the cure rate of acute severe carbon monoxide poisoning Each treatment group compared with control group, the cure rate of 400 mg group and 600 mg group is significantly higher than the control group(P<0.05).1.2 Effect of different concentrations of niacin therapy on acute severe total effective rate of carbon monoxide poisoning Each treatment group compared with control group,the total effective rate of 400 mg group and 600 mg group is significantly higher than the control group.1.3 Effect of different concentrations of niacin therapy group for acute severe carbon monoxide poisoning on the rate of improvement The treatment group compared with control group, there was no significant difference between groups,(P> 0.05).1.4 Different doses of niacin therapy group carbon monoxide poisoning affect the number of days of hospitalization for acute severe carbon monoxidepoisoning Each treatment group compared with the control group, which 200 mg,400mg group, 600 mg group, length of hospital stay was significantly lower than the control group was statistically significant(P<0.05). Meanwhile200 mg group, 400 mg group, 600 mg group pairwise comparison, there are significant differences in each group(P<0.05).1.5 Different doses of niacin therapy group carbon monoxide poisoning affect the cost of hospitalization for acute severe carbon monoxide poisoning Each treatment group compared with the control group, which 200 mg, 400 mg group, 600 mg group hospitalization costs were significantly lower than the control group was statistically significant(P<0.05). Meanwhile 200 mg group,400 mg group, 600 mg group pairwise comparison, there are significant differences in each group(P<0.05)..1.6 Effect of different concentrations of nicotinic acid treatment on the influence of the SOD activity in patients with acute severe carbon monoxide poisoning Treatment 7 days 200 mg, 400 mg, 600 mg group compared with control group, the SOD activity is significantly higher than the control group(P< 0.05,Fig. 4, Table 3). While 400 mg, 600 mg group compared with 200 mg group,SOD activity of 600 mg group was obviously higher than that of 200 mg group, with statistical significance(P< 0.05).Treatment for 14 days 200 mg, 400 mg, 600 mg group compared with control group, the SOD activity is significantly higher than the control group, there was statistical significance(P< 0.05, Fig. 4, Table 3). At the same time 400 mg,600 mg group compared with 200 mg group, SOD activity is significantly higher than 200 mg group, with statistical significance(P< 0.05).Treatment of 21 days 200 mg, 400 mg,600 mg group compared with control group, the SOD activity is significantly higher than the control group,with statistical significance(P< 0.05, Fig. 4, Table 3). While 400 mg, 600 mg group compared with 200 mg group, no obvious difference was found between SOD activity, no statistical significance(P> 0.05).1.7 Effect of different concentrations of niacin treatment the influence of the level of MDA in patients with severe acute carbon monoxide poisoning Treatment for 7 days 200 mg, 400 mg, 600 mg group compared with control group, the MDA content significantly lower than the control group,there was statistical significance(P< 0.05, Fig. 5, Table 4). At the same time to200 mg, 400 mg, 600 mg group are compared, and two found no difference between the groups of MDA content, there is no statistical significance(P>0.05)Treatment for 14 days 200 mg, 400 mg, 600 mg group compared with control group, the MDA content significantly lower than the control group,there was statistical significance(P < 0.05, Fig. 5, Table 4). At the same time to 200 mg, 400 mg, 600 mg group are compared, and two found no difference between the groups of MDA content, there is no statistical significance(P >0.05)Treatment of 21 days 200 mg, 400 mg, 600 mg group compared with control group, the MDA content significantly lower than the control group,there was statistical significance(P < 0.05, Fig. 5, Table 4). At the same time to 200 mg, 400 mg, 600 mg group are compared, and two found no difference between the groups of MDA content, there is no statistical significance(p >0.05)2 Different concentrations of nicotinic acid on acute severe carbon monoxide poisoning prevention of delayed encephalopathy The treatment group compared with control group, including 200 mg,400 mg, 600 mg, the cure rate of the treatment group is significantly higher than the control group(P< 0.05).Conclusion: the serum MDA level of the patients with SOD was lower than that of the control group. The serum SOD activity of the serum was higher than that of the control group, which suggested that nicotinic acid could enhance the activity of antioxidant enzymes in the body and enhance the antioxidant capacity of the body. Reduce the content of MDA in vivo, and reduce the brain damage caused by lipid peroxidation(LPO), and thus, theoxidative stress caused by carbon monoxide. Large dose of nicotinic acid in the treatment of ACOP is effective, the incidence of DEACMP was significantly decreased, which has important guiding significance for clinical treatment. At the same time, the use of nicotinic acid on the treatment of carbon monoxide poisoning patients can shorten the length of hospital stay,reduce the cost of hospitalization, with a certain social and economic benefits. |
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