Serum levels of endothelin-1, tumor necrosis factor-α and its clinical significance in patients with delayed encephalopathy after acute carbon monoxide poisoning

Abstract

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. Key words: Carbon monoxide poisoning; Neurotoxicity syndrome; Tumor necrosis factor-α; Endothelin- 1