血液学指标在评估心肺复苏成功患者预后中的临床价值  

The value of haematological index in estimating prognosisfor of patients after successful cardiopulmonary resuscitation

作　　者：邓磊[1] 杨鹏[1] 常莉[1] DENG Lei;YANG Peng;CHANG Li(Department of Emengency ICU, Sichuan People 9 s Hospital, Chengdu 610012 , Sichuan, China)

机构地区：[1]四川省医学科学院·四川省人民医院急诊ICU,四川成都610072

出　　处：《川北医学院学报》2017年第4期564-566,573,共4页Journal of North Sichuan Medical College

摘　　要：目的:探索血液学指标在评估心肺复苏(cardiopulmonary resuscitation,CPR)成功患者预后的诊断价值。方法:分析我院成功获得CPR的84例老年心脏骤停患者的临床资料,依据患者在CPR成功后是否发生复苏后综合征(post resuscitation syndrome,PRS)分为观察组(发生,n=43)及对照组(未发生,n=41)。检测两组患者CPR成功后24~48 h外周血白介素-6(IL-6)、B型钠尿肽(BNP)与肌钙蛋白Ⅰ(TNI)水平,并分析以上指标对CPR后综合征发生的预测诊断价值。结果:观察组患者血清IL-6、BNP及TNI水平均显著高于对照组,均具有统计学意义(P<0.05)。ROC曲线分析显示,以35.96 ng/L为截点值,IL-6对CPR发生的预测诊断敏感性为83.72%,特异性为82.93%,曲线下面积为0.83,优于BNP及TNI。观察组患者外周血IL-6水平与BNP(r=0.493,P<0.01)及TNI(r=0.484,P<0.01)均呈现显著正相关关系,均具有统计学意义(P<0.05)。结论:IL-6水平对获得CPR成功患者的预后具有一定预测诊断价值,值得临床推广。Objective:To explore the diagnostic value of haematological index in estimating prognosisfor of patients after suc-cessful cardiopulmonary resuscitation(CPR).Methods:84patients undergoing cardiac arrest in our hospital were selected,and divided into the observation group(n=43,yes)and the control group(n=41,no)according to whether suffer from post resuscitation syn-drome(PRS).The levels of Interleukin-6(IL-6),B-type natriuretic peptide(BNP),Troponin I(TNI)and after successful CPR with24?48h in the patients of the two groups were detected,and the diagnostic value of haematological index in estimating CPR was ana-lyzed.Results:The levels of IL-6,BNP and TNI in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).ROC analysis showed that the IL-6cut-off point value of35.96ng/L,as used for post CPR syndrome,provided a sensitivity of83.72%,a specificity of82.93%,an Area under the curve of0.83,better than these of BNP and TNI.Correlation analysis showed that,for the patients in the observation group,the levels of IL-6had significant positive corre-lation with BNP(r=0.493,P<0.01)and TNI(r=0.484,P<0.01),all had statistical significance.Conclusion:IL-6can be used as a marker to estimating in estimating prognosisfor of patients after successful CPR,be worthy of clinical promotion.

关 键 词：心肺复苏 复苏后综合征 白介素-6 B型钠尿肽 肌钙蛋白I 

分 类 号：R459.7[医药卫生—急诊医学]