心肺复苏后血管紧张素Ⅱ改变与预后关系研究  

Prognosis meaning of the serum angiotensin Ⅱ change in patients undergoing cardiopulmonary resuscitations

作　　者：黄兴国[1] 霍开秀[1] 何卫平[2] 王晓川[1] 李复雄[1] 尹学念[1] 

机构地区：[1]深圳市第九人民医院(原深圳市龙岗中心医院)传染科,广东省深圳518116 [2]广东省深圳市第二人民医院急诊ICU

出　　处：《中国基层医药》2006年第7期1063-1064,共2页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省深圳市科技局立项(200304269)

摘　　要：目的探讨心肺复苏后患者血管紧张素Ⅱ的变化与预后的关系。方法(1)对62例心肺复苏自主循环维持24h以上的患者于住院后第1、3、5、7天晨7∶30侧定AngⅡ的浓度,同时进行动脉血气分析,记录平均动脉血压和发生再灌注心律失常等情况。(2)35例正常对照组测定AngⅡ1次。结果(1)复苏后患者住院第1、3、5、7天AngⅡ的浓度分别为(97·69±13·35)ng/L、(120·65±16·39)ng/L、(131·12±19·84)ng/L和(128·33±25·32)ng/L,均比正常人对照组的(63·70±9·71)ng/L显著升高(P<0·01)。(2)死亡患者不同时期AngⅡ、PaCO2明显高于存活者(P<0·05或P<0·01);而pH值、PaO2和平均动脉血压均显著低于存活者(P<0·05或P<0·01)。(3)死亡者不同时期发生快速型室上性、室性心律失常均比存活者显著增多(P<0·05)。结论心跳呼吸骤停复苏后患者体内始终存在AngⅡ升高,且微循环严重障碍,易发生再灌注心律失常,病情严重、预后差。AngⅡ可作为评估心肺复苏后患者预后的有效指标。Objective To explore the prognosis meaning of the change of the angiotensin Ⅱ （Ang Ⅱ ） in patients undergoing cardiopulmonary resuscitation（CPR）. Methods （1）The changes of the Ang Ⅱ , gas analysis of arterial blood,mean blood pressure（MBP） and reperfusion arrhythmia（RA） were observed in 62 cardiac arrest patients who have treated with CPR on 1,3,5 and 7 days after admission. （2）Plasma levels of Ang Ⅱ in 35 normal adults were measured only. Results （ 1 ）On 1,3,5 and 7 days after admission,plasma levels of Ang Ⅱ in patients undergoing CPR （97.69± 13.35）ng/L,（120.65± 16.39）ng/L,（131.12 ± 19.84）ng/L and （128.33 ± 25.32）ng/L were significantly higher than those in normal adults （63.70-± 9.71 ）ng/L（ P 〈 0.01 ）. （2）On defferent period, the Ang Ⅱ and PaCO2 in death patients were obviously higher than those in survival persons（ P 〈 0.05 or P 〈 0.01 ） ; But pH,PaO2 and MBP in death patients were conspicuously lower than those in survival persons（ P 〈 0.05 or P 〈 0.01）. （3）On defferent period, higher incidences of supraventricular and ventricular tachyarrhythmia in death patients were significantly higher than those in survival patients（P 〈 0.05）. Conclusion Plasma level of Ang Ⅱ after successful CPR is always very high, and microcirculation is failure, easily takes place reperfusion arrhythmia. This predicts more severe disease, wores prognosis after successful CPR.

关 键 词：心肺复苏术 血管紧张素Ⅱ 预后 

分 类 号：R459.7[医药卫生—急诊医学]