血清髓过氧化物酶水平与心肺复苏术后自主循环恢复患者预后关系的研究  

The correlation of serum myeloperoxidase and the prognosis in patients undergoing cardiopulmo-nary resuscitation with return of spontaneous circulation

作　　者：李长罗[1] 周利平[2] 龙勇[1] 袁锋[1] 黄国庆[2] 杨宁[2] 

机构地区：[1]长沙市中心医院急诊科, 湖南长沙410004 [2]中南大学湘雅医院急诊科, 湖南长沙410008

出　　处：《中国急救医学》2016年第7期639-642,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的：观察心脏骤停经心肺复苏术（CPR）后自主循环恢复（ROSC）的患者血清髓过氧化物酶（MPO）水平变化，探讨MPO与疾病预后的关系。方法在急诊科收集心脏骤停经CPR后ROSC的患者作为研究对象，观察其存活及诊治情况，详细记录临床资料，从CPR开始选取6个时间点，抽取外周静脉血，用酶联免疫法检测血清中MPO水平。结果共收集临床病例248例，其中134例患者在ROSC后3 h内死亡；32例患者在ROSC后3 h以上，6 h以内死亡；12例患者在ROSC后6 h以上，12 h以内死亡；5例患者在ROSC后12 h以上，24 h以内死亡；35例患者在ROSC后24 h以上，20 d以内死亡；30例患者存活在ROSC后20 d以上。ROSC后3 h内死亡的134例患者血清MPO水平与其他114例患者血清MPO水平差异有统计学意义（P＜0.05）；ROSC后存活24 h以上，但在20 d以内死亡的35例患者与ROSC后存活20 d以上的30例患者比较各时间点血清MPO水平差异均无统计学意义（P＞0.05）。结论血清MPO水平可能与CPR后ROSC的患者近期预后有关，血清MPO水平越高，预后越差；但血清MPO水平可能不能用来判断此类患者的远期预后。Objective To investigate a potential correlation of circulating myeloperoxidase （MPO） and prognosis in cardiac arrest patients who have return of spontaneous circulation （ROSC）. Methods Circulating MPO was measured by an enzyme-linked immunosorbent assay. Serum was collected at various time points after the initiation of cardiopulmonary resuscitation （CPR） in 248 patients who presented to the Emergency Department due to normothermic, nontraumatic cardiac arrest and had eventual ROSC. Results MPO levels of 134 patients who dead 3 hours post-ROSC was obviously higher than the MPO levels of the remaining 114 patients at various time points of CPR. MPO levels had no differences at any time points between 30 patients who survived more than 20 days post-ROSC and 35 patients who survived more than 24 hours, but less than 20 days post-ROSC. In addition, MPO levels elevated over time within 24 hours post-ROSC for all patients. Conclusion MPO may be associated with short-term prognosis of patients undergoing CPR with ROSC, but it can not help predict long-term outcomes. Further investigations will be done to demonstrate the relationships between MPO levels and prognosis of patients undergoing CPR with ROSC.

关 键 词：髓过氧化物酶(MPO) 心脏骤停 心肺复苏(CPR) 缺血-再灌注损伤 自主循环恢复(ROSC) 

分 类 号：R743.31[医药卫生—神经病学与精神病学]