高级氧化蛋白产物在心肺脑复苏后的检测及其意义  

The Role and Clinical Significance of Advanced Oxidized Protein Products in Patients after Cardiopulmonary-cerebral Resuscitation

作　　者：熊艳[1] 詹红[1] 李玉杰[1] 李欣[1] 荆小莉[1] 廖晓星[1] 

机构地区：[1]中山大学附属第一医院急诊科,510080

出　　处：《岭南急诊医学杂志》2008年第5期325-326,329,共3页Lingnan Journal of Emergency Medicine

基　　金：广州市重大科技攻关项目(2004Z32E0381)

摘　　要：目的:探讨心搏骤停患者经心肺脑复苏(CPCR)后体内高级氧化蛋白产物(AOPP)的变化及其临床意义。方法:用分光光度计法检测心搏骤停患者经CPCR后外周静脉血清AOPP浓度,同时对心肺脑复苏后患者进行急性生理学与慢性健康状况(APACHE) Ⅲ评分,并记录30天内患者的生存或死亡情况,分析血清AOPP浓度与器官功能障碍程度和病情转归的关系。结果:血清AOPP水平和APACHE Ⅲ评分在PR-MODS组[(156.60±28.04)mol/L,(96.39±24.78)分]和死亡组[(189.92±34.86)mol/L,(110.46±32.47)分]分别明显高于非PR-MODS组[(88.76±10.13)mol/L,(69.34±16.33)分]和存活组[(128.49±36.65)mol/L,(78.65±20.92)分](P<0.05);血清AOPP水平和APACHE Ⅲ评分呈高度正相关(r=0.528,P<0.01)。结论:心搏骤停和CPCR过程激活机体氧化应激状态,蛋白质氧化应激产物增加,AOPP水平对PR-MODS的发生及判断病情轻重和预后评估具有重要参考价值。Objective： To investigate the role and clinical significance of advanced oxidized protein products （AOPP） in patients after cardiopulmorary-cerebral resuscitation. Methods： Serum AOPP levels were determined in 46 patients after cardiopulmonary-cerebral resuscitation. APACHE Ⅲ scoring system was applied to assess patients＇ severity. The differences of serum AOPP among post-resuscitation multiple organ dysfunction syndrome （PR-MODS） group, non-PR-MODS group and normal control group, together with differences between survival and dead subjects within 30 days, were compared. The correlations between AOPP levels and APACHE Ⅲ score were also observed. Results： The AOPP levels and APACHE Ⅲ score-in both PR-MODS group [（156.60±28.04）mol/L, （96.39±24.78）] and death group[ （189.92±34.86） mol/L, （110.46±32.47）] were higher than those in non-PR-MODS group[ （88.76± 10.13 ） mol/L, （69.34 ± 16.33 ） ] and survival group [ （ 128.49 ±36.65 ） mol/L, （78.65 ±20.92） 分 ], respectively （P〈 0.05）. Positive correlations were noted between AOPP levels and APACHE Ⅲ score （r =0.528, P〈0.01）. Conclusion： Cardiac arrest and the CPCR procedure can activate oxidative stress and induce the formation of AOPP. AOPP may play an important role in the pathophysiology of PR-MODS.The serum AOPP level may be taken as a diagnostic and prognostic indicator for PR-MODS.

关 键 词：心肺脑复苏 氧化应激 多脏器功能障碍综合征 高级氧化蛋白产物 

分 类 号：R459.7[医药卫生—急诊医学]