心脏停搏患者心肺复苏自主循环恢复后高淀粉酶血症的研究  

Study on hyperamylasemia after recovery of spontaneous circulation in cardiac arrest

作　　者：孟庆义[1] 李玉范[1] 张志强[1] 苏绍萍[1] 刘刚[1] 沈洪[1] 

机构地区：[1]解放军总医院急诊科,北京100853

出　　处：《中国危重病急救医学》2001年第10期618-620,共3页Chinese Critical Care Medicine

基　　金：解放军总医院科研基金资助项目 ( No.YQ0 0 2 )

摘　　要：目的 :探讨心脏停搏患者自主循环恢复后高淀粉酶血症的临床意义。方法 :对 3 2例心肺复苏患者高淀粉酶血症情况进行系统观察。结果 :心肺复苏患者中有 62 .5% ( 2 0 / 3 2 )的患者存在高淀粉酶血症现象〔血清淀粉酶活力 1 50～ 2 890 U/ L ,其中血清淀粉酶 >4 0 0 U/ L 2 4小时存活组 1 3例中 3例 ( 2 3 .1 % )明显低于死亡组 1 9例中有 1 0例 ( 52 .6% ) ,差异接近显著 ( P=0 .0 76)〕。且血清淀粉酶活力与动脉血二氧化碳分压 ( PCO2 )呈显著正相关 ( r=0 .563 77,P<0 .0 1 ) ,与氧分压 ( PO2 )呈显著负相关 ( r=-0 .4 2 54 9,P<0 .0 5)。结论 :心脏停搏患者自主循环恢复后的高淀粉酶血症可能与胰腺缺血再灌注损伤和原发疾病有关 ,并在估计患者预后方面有一定的意义。Objective:To study the clinical significance of hyperamylasemia after recovery of spontaneous circulation in cardiac arrest.Methods:Somogyi method was used to determine the serum activity of amylase,and the changes in serum amylase activities were observed in 32 cases with cardiopulmonary resuscitation (CPR).Results:The incidence of hyperamylasemia was 62 5% (20/32) in CPR cases (1502 890 U/L).Only 3 out of 13 cases (23 1%) had serum amylase activity exceeding 400 U/L in the survived group within 24 hours ,while 10 out of 19 cases in the fatal group (52 6%, P =0 076).In addition,the levels of serum amylase were positively correlated with PCO 2 ( r =0 563 77, P <0 01) and negatively correlated with PO 2 ( r = 0 425 49, P <0 05).Conclusions:The hyperamylasemia after recovery of spontaneous circulation in cardiac arrest might be related to pancreas ischemiareperfusion injury and the primary disease.This can help us to estimate the prognosis of cardiac arrest.

关 键 词：心脏停搏 心肺复苏 淀粉酶 血清 

分 类 号：R459.8[医药卫生—治疗学]