血清GDF-15、cTNI联合检测与心肺复苏患者心功能及其近期预后的关系  

Changes of serum GDF-15 and cTNI after cardiopulmonary resuscitation and recent clinical prognosis

作　　者：周景霞[1] 任长安[2] 刘春涛[1] 李忠[2] 张新颖[1] 于海侠[2] 

机构地区：[1]河北省承德市中心医院重症医学科,河北承德067000 [2]河北省承德市中心医院急诊科,河北承德067000

出　　处：《中国现代医学杂志》2017年第17期93-97,共5页China Journal of Modern Medicine

基　　金：河北省承德市科学技术研究与发展计划(No:20142009)

摘　　要：目的探讨心脏骤停心肺复苏(CPR)成功后的患者血清生长分化因子-15(GDF-15)、肌钙蛋白Ⅰ(c TNI)不同时间的水平变化及其与心功能、近期预后的关系。方法分别检测102例CPR患者CPR后即刻、12 h、24~48 h的血清GDF-15水平,根据血清GDF-15升高时间分为3组,A组:CPR后即刻、12 h、24~48 h血清GDF-15水平持续<1200ng/L;B组:CPR后12h和24~48h GDF-15水平持续升高,且持续>1 200 ng/L;C组:CPR后12 h和24~48 h GDF-15水平持续升高,但24~48 h较12 h降低。同时检测3组患者各时间血清c TNI水平,并测定各时间左心室舒张末内径(LVEDD),左室射血分数(LVEF),随访3组患者CPR后6个月的死亡情况。结果 GDF-15和c TNI水平具有交互作用(P<0.05),即c TNI表达水平随着血清GDF-15的变化而变化。同时发现,LVEDD和LVEF随着GDF-15和c TNI水平的变化而变化。B组死亡率高于A组和C组(P<0.05),A组死亡率与C组比较,差异无统计学意义(P>0.05);随访6个月结果显示,B组患者生存率低于A组和C组(P<0.05),A组与C组比较,差异无统计学意义(P>0.05)。GDF-15高水平组(>1 800 ng/L)、c TNI高水平组(>1.5 ng/ml)患者死亡率均高于GDF-15、c TNI低水平组(P<0.05)。结论血清GDF-15与c TNI联合检测有望成为预测CPR患者近期预后的良好指标。Objective To explore the changes of serum levels of growth defferentiation factor-15 （GDF-15） and troponin Ⅰ （cTNI） at different time after successful cardiopulmonary resuscitation （CPR） and their relationships with cardiac function and the recent clinical prognosis of CPR. Methods A total of 102 victims who received CPR for sudden cardiac arrest were divided into three groups. The victims whose GDF-15 level was under 1,200 ng/L were enrolled into group A; those whose GDF-15 level continued to increase 12 h and 24-48 h after CPR and was over 1,200 ng/L were included into group B; and group C included those whose GDF-15 level increased 12 h after CPR but was lowered 24-48 h after CPR. Serum cTNI, left vetricle end-diastolic diameter （LVEDD）, left ventricle ejection fraction （LVEF） were detected in the three groups at different time. The patients were followed up for 6 m and the mortality was calculated. Results The cTNI level changed with the change of GDF-15. LVEDD and LVEF also changed with the changes of GDF-15 and cTnI levels. The mortality of the group B was obviously higher than that of the group A and the group C （P〈0.05）. The mortality of the group C was slightly higher than that of the group A （P〉0.05）. Conclusions The joint detection of serum GDF-15 and cTNI can well predict the recent clinical outcomes of the patients receiving CPR.

关 键 词：心肺复苏 生长分化因子-15 肌钙蛋白Ⅰ 近期临床预后 

分 类 号：R459.7[医药卫生—急诊医学]