| Objective To observe the evolution pattern of total leukocyte count,serum C-reactive protein,creatine kinase and lactic acid in patients with simple acute carbon monoxide poisoning(ACMP)and delayed encephalopathy after acute carbon monoxide intoxication(DEACMP).Estimated the probability of development to DEACMP by the blood testing.Methods Two hundred and forty-two consecutive patients with acute carbon monoxide poisoning were recruited(100 males and 142 females),among whom 42 patients developed DEACM.Blood samples were obtained from enrolled patients and 60 normal healthy controls.Total leukocyte count,serum C-reactive protein,creatine kinase and lactic acid levels were detected on the 1St day,3rd day,7th day after ACMP.Patients were grouped by gender and disease nature.The blood test results were analyzed according to sampling time.Group A,B,C,D referred to blood sample collected at the time of<24h(inclusive),24h-72h(inclusive),72h-168h(inclusive),>168h,respectively.Positive signs of ACMP were recorded.All data were statistically analyzed by SPSS 17.0.Results:During hospitalization,the mean total leukocyte count of male healthy control group,simple ACMP group and DEACMP group were 4.93±1.16×1 09/L,6.35±2.99x109/L,8.75±6.82x109/L respectively,and 4.82±1.14x×109/L、5.91±2.91×109/L.10.01±4.76x109/L for female.The mean serum lactic acid of male healthy control group,simple ACMP group and DEACMP group were 1.37±0.56mmol/L.1.87±0.69 mmol/L.3.44±5.47 mmol/L respectively,and 1.25±0.41 mmol/L.2.07±0.59 mmol/L、2.14±0.60 mmol/L for female.The serum CRP of male healthy control group,simple ACMP group and DEACMP group were 4.40±2.56mg/L.18.87±28.40 mg/L.30.27±35.12 mg/L respectively,and 4.64±2.65 mg/L、13.82±8.05 mg/L、14.85±6.13 mg/L for female.The serum CK of male healthy control,simple ACMP group and DEACMP group were 94.47±59.56 U/L,435.29±771.84 U/L,525.72±738.5 U/L respectively,and 91.79±43.62 U/L、292.80±390.78 U/L.370.24±386.68 U/L for female.The total leukocyte count,serum CK and CRP of ACMP group(both ACMP and DEACMP)were significantly higher than healthy control group(P<0.05 for total leukocyte count,P<0.01 for CK and CRP),and were gender difference.In male patients,the total leukocyte count and serum lactic acid level of simple ACMP group and DEACMP group showed statistically significant difference after 72h of poisoning(P<0.01),the serum CRP showed statistically significant difference after 168h of poisoning(P<0.01).In female patients,the total leukocyte count of ACMP group and DEACMP group showed statistically significant difference in 24h of poisoning(P<0.01),the serum lactic acid and CRP levels of ACMP group and DEACMP group may show statistically significant difference after 168h of poisoning(there was only one female patient in D group).The incidence of coma is significantly different between simple ACMP group and DEACMP group(x2 =5.74,P<0.05 for male group;x2=13.22,P<0.01 for female group)for male and female。The incidence of incontinence of urine and feces is significantly different between simple ACMP group and DEACMP(x2 =5.91,P<0.05)for female.The incidence of sequela after discharge is significantly different between simple ACMP group and DEACMP(x2 =7.41,P<0.01)for male.Conlusions Total leukocyte count is a sensitive early predictor of DEACMP.The reaction time and degree of leukocyte is different between male and female patients.The escalating serum CRP and lactic acid were advanced evaluation indicators for DEACMP in male,maybe in female too,but last longer than male.The history of coma,incontinence of urine and feces,sequela after discharge are predictors of DEACMP,but has a different significance in male and female.Positive signs revealed by physical examination,combined with total leukocyte count,serum CRP and lactic acid,is of predictive value for DEACMP. |
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