心肺复苏患者血清和肽素水平的临床意义(1)
[摘要] 目的 探讨心脏骤停患者心肺复苏(cardio-pulmonary resuscitation，CPR)不同时间点血清和肽素水平及变化与近期预后的关系。 方法 分别检测175例心脏骤停患者在CPR 5 min、15 min、恢复自主循环(restoration of spontaneous circulation，ROSC)成功或失敗时等不同时间点血清和肽素水平。以ROSC成功或者失败进行分组，比较两组之间血清和肽素水平的差异，并综合两组间的性别、年龄、心脏骤停时间、病因等影响因素进行多因素回归分析。 结果 ROSC成功组患者血清和肽素水平[分别为(15.21±3.01)pmol/L、(20.12±5.10)pmol/L、(25.50±8.24)pmol/L]显著高于ROSC失败组患者[分别为(11.25±3.72)pmol/L、(12.63±3.61)pmol/L、(13.51±4.05)pmol/L](P<0.01)；血清和肽素水平与ROSC成功率具有显著相关性(P<0.05)。 结论 检测血清和肽素水平有助于预测心肺骤停患者ROSC成功率。
[关键词] 心肺复苏；和肽素；预后
[中图分类号] R459.7 [文献标识码] A [文章编号] 1673-9701(2017)10-0019-04
Clinical significance of serum copeptin levels in the patients receiving cardiopulmonary resuscitation
XIANG Gongqiang1 XIA Xiaole1 ZHANG Wanli1 WU Xianchun1 XU Dezhong1 WANG Guosheng2
1.Department of Emergency， the First People's Hospital of Longwan District of Wenzhou City in Zhejiang Province， Wenzhou 325024， China； 2.Department of Laboratory， the First People's Hospital of Longwan District of Wenzhou City in Zhejiang Province， Wenzhou 325024， China
[Abstract] Objective To investigate the relationship between serum copeptin level and its changes and short-term prognosis of cardiopulmonary resuscitation(CPR) at different time points in the patients with cardiac arrest. Methods Levels of serum copeptin in 175 patients with cardiac arrest were measured at 5 minutes and 15 minutes of CRP， and at success or failure of restoration of spontaneous circulation(ROSC). The patients were assigned to groups according to ROSC success or failure， and the differences in serum copeptin levels were compared between the two groups. The influencing factors such as gender， age， cardiac arrest time， and etiology were summarized in the two groups to perform multivariate regression analysis. Results Serum copeptin levels in the ROSC success group[(15.21±3.01)pmol/L， (20.12±5.10)pmol/L， (25.50±8.24)pmol/L respectively] were significantly higher than those in the ROSC failure group [(11.25±3.72)pmol/L， (12.63±3.61)pmol/L， (13.51±4.05)pmol/L respectively](P<0.01)； serum copeptin levels were significantly correlated with ROSC success rate(P<0.05). Conclusion The detection of serum copeptin levels can help to predict the success rate of ROSC in patients with cardiopulmonary arrest.
[Key words] Cardiopulmonary resuscitation (CPR)； Copeptin； Prognosis
心脏骤停后的心肺复苏(cardio-pulmonary resuscitation，CPR)是一项分秒必争的抢救过程，尽快地恢复自主循环(restoration of spontaneous circulation，ROSC)非常重要。近年来倾向于延长复苏时间以期提高存活率[1]，各种辅检指标更多地是在ROSC后用以评估病情与预后[2]，但在CPR期间能准确预估ROSC或存活率的指标比较缺乏。和肽素(copeptin)是一种新近发现的生物标志物，具有易保存、易检测等优点[3，4]。诸多研究表明其在神经系统损伤、心血管疾病、危重症等疾病的早期诊断及预后评估方面有着重要的临床价值[5]，在ROSC后生存率的相关性研究亦有报道[6，7]，但在CPR中预估ROSC方面较少报道。本文通过对我院急诊科175例心跳呼吸骤停患者的血清和肽素水平进行检测，探讨其在CPR过程中预测ROSC成功率的价值，现报道如下。, http://www.100md.com(项公强 夏晓乐 张万里 吴显春 许德忠 王国胜)
[关键词] 心肺复苏；和肽素；预后
[中图分类号] R459.7 [文献标识码] A [文章编号] 1673-9701(2017)10-0019-04
Clinical significance of serum copeptin levels in the patients receiving cardiopulmonary resuscitation
XIANG Gongqiang1 XIA Xiaole1 ZHANG Wanli1 WU Xianchun1 XU Dezhong1 WANG Guosheng2
1.Department of Emergency， the First People's Hospital of Longwan District of Wenzhou City in Zhejiang Province， Wenzhou 325024， China； 2.Department of Laboratory， the First People's Hospital of Longwan District of Wenzhou City in Zhejiang Province， Wenzhou 325024， China
[Abstract] Objective To investigate the relationship between serum copeptin level and its changes and short-term prognosis of cardiopulmonary resuscitation(CPR) at different time points in the patients with cardiac arrest. Methods Levels of serum copeptin in 175 patients with cardiac arrest were measured at 5 minutes and 15 minutes of CRP， and at success or failure of restoration of spontaneous circulation(ROSC). The patients were assigned to groups according to ROSC success or failure， and the differences in serum copeptin levels were compared between the two groups. The influencing factors such as gender， age， cardiac arrest time， and etiology were summarized in the two groups to perform multivariate regression analysis. Results Serum copeptin levels in the ROSC success group[(15.21±3.01)pmol/L， (20.12±5.10)pmol/L， (25.50±8.24)pmol/L respectively] were significantly higher than those in the ROSC failure group [(11.25±3.72)pmol/L， (12.63±3.61)pmol/L， (13.51±4.05)pmol/L respectively](P<0.01)； serum copeptin levels were significantly correlated with ROSC success rate(P<0.05). Conclusion The detection of serum copeptin levels can help to predict the success rate of ROSC in patients with cardiopulmonary arrest.
[Key words] Cardiopulmonary resuscitation (CPR)； Copeptin； Prognosis
心脏骤停后的心肺复苏(cardio-pulmonary resuscitation，CPR)是一项分秒必争的抢救过程，尽快地恢复自主循环(restoration of spontaneous circulation，ROSC)非常重要。近年来倾向于延长复苏时间以期提高存活率[1]，各种辅检指标更多地是在ROSC后用以评估病情与预后[2]，但在CPR期间能准确预估ROSC或存活率的指标比较缺乏。和肽素(copeptin)是一种新近发现的生物标志物，具有易保存、易检测等优点[3，4]。诸多研究表明其在神经系统损伤、心血管疾病、危重症等疾病的早期诊断及预后评估方面有着重要的临床价值[5]，在ROSC后生存率的相关性研究亦有报道[6，7]，但在CPR中预估ROSC方面较少报道。本文通过对我院急诊科175例心跳呼吸骤停患者的血清和肽素水平进行检测，探讨其在CPR过程中预测ROSC成功率的价值，现报道如下。, http://www.100md.com(项公强 夏晓乐 张万里 吴显春 许德忠 王国胜)