The purpose of this research was to assess the value of homocysteine (HCY) levels in predicting cognitive dysfunction in patients after acute carbon monoxide (CO) poisoning. A total of 115 patients who were admitted to the emergency department of Yinzhou NO. 2 Hospital after CO poisoning between January 2017 and December 2021 were enrolled in this retrospective study. All patients were followed up for 1 month. According to the Mini–Mental State Examination (MMSE) scores, patients were divided into two groups. The demographic and clinical characteristics and magnetic resonance imaging (MRI) results were gathered and statistically analysed. Twenty-six and 89 patients were ultimately enrolled in the cognitive dysfunction and control groups, respectively. There were significant differences between the groups in terms of age, coma duration, and carboxyhaemoglobin (COHB), lactate and HCY levels (p < 0.05), but there were no significant differences in white blood cell (WBC) counts or aspartate transaminase (AST), alanine transaminase (ALT), creatinine, troponin T, creatinine kinase (CK), or creatinine kinase muscle and brain (CK-MB) levels (p > 0.05). Univariate and multivariate analyses identified that a higher HCY level (OR 2.979, 95% CI 1.851-5.596, p < 0.001) was an independent risk factor for patient cognitive dysfunction after acute CO poisoning. Linear regression analysis showed a negative correlation between MMSE scores and HCY levels (r = − 0.880, P < 0.001). According to the MRI results, the most common lesion site was the globus pallidus, and the central ovale, diffuse white matter, corona radiata, basal ganglia (other than the globus pallidus) and cerebral cortex were also involved. Higher HCY levels were associated with cognitive impairment and were independent risk factors for cognitive impairment after acute CO poisoning. The level of HCY was negatively correlated with the degree of cognitive impairment.

中文翻译：

---

同型半胱氨酸水平对急性一氧化碳中毒患者认知功能障碍的预测价值研究

本研究的目的是评估同型半胱氨酸 (HCY) 水平在预测急性一氧化碳 (CO) 中毒后患者认知功能障碍中的价值。鄞州一号急诊科共收治患者115人。2017 年 1 月至 2021 年 12 月期间 CO 中毒后的 2 家医院被纳入本回顾性研究。所有患者均随访1个月。根据简易精神状态检查（MMSE）评分，将患者分为两组。收集并统计分析人口统计学和临床​​特征以及磁共振成像（MRI）结果。最终分别有 26 名和 89 名患者被纳入认知功能障碍组和对照组。各组在年龄、昏迷持续时间、和碳氧血红蛋白 (COHB)、乳酸和 HCY 水平 (p < 0.05)，但白细胞 (WBC) 计数或天冬氨酸转氨酶 (AST)、丙氨酸转氨酶 (ALT)、肌酐、肌钙蛋白 T、肌酐激酶无显着差异(CK) 或肌酐激酶肌肉和脑 (CK-MB) 水平 (p > 0.05)。单变量和多变量分析表明，较高的 HCY 水平（OR 2.979，95% CI 1.851-5.596，p < 0.001）是急性 CO 中毒后患者认知功能障碍的独立危险因素。线性回归分析显示 MMSE 评分与 HCY 水平呈负相关（r = - 0.880，P < 0.001）。根据MRI结果，最常见的病变部位是苍白球、中央卵圆、弥漫性白质、放射冠、基底神经节（苍白球除外）和大脑皮层也受累。较高的 HCY 水平与认知障碍相关，并且是急性 CO 中毒后认知障碍的独立危险因素。HCY水平与认知障碍程度呈负相关。