心肺复苏后自主循环恢复患者预后状况与复苏后1 h内血清P选择素、E选择素、HIF-2α水平研究  

Correlation of serum P-selectin, E-selectin and HIF-2α levels within 1 h of resuscitation with the prognosis of patients undergoing return of spontaneous circulation after cardio-pulmonary resuscitation

作　　者：徐樱 阳毅临 伍果美 XU Ying;YANG Yi-lin;WU Guo-mei(Department of Rehabilitation Medicine,Changsha Third Hospital,Changsha Hunan 410011,China;Department of Geriatrics,Changsha Third Hospital,Changsha Hunan 410011,China)

机构地区：[1]长沙市第三医院康复医学科,湖南长沙410011 [2]长沙市第三医院老年病科,湖南长沙410011

出　　处：《临床和实验医学杂志》2022年第23期2568-2571,共4页Journal of Clinical and Experimental Medicine

基　　金：湖南省卫生健康委科研计划项目(编号:20201270)。

摘　　要：目的探究心肺复苏后自主循环恢复患者预后状况与复苏后1 h内血清P选择素、E选择素、缺氧诱导因子-2α(HIF-2α)水平研究。方法采用回顾性研究分析选取2018年1月至2020年12月长沙市第三医院老年病科收治的240例心肺复苏自主循环恢复患者为研究对象。根据出院结局分为存活组131例和死亡组109例。对可能引起心肺复苏预后相关指标分别进行单因素分析与多因素分析。并在复苏后1 h内对两组患者进行血清采集与测定P选择素、E选择素、HIF-2α水平,及病情预后进行相关性研究。结果单因素Logistic回归分析发现性别、年龄、基础病史对两组患者预后无显著影响,差异均无统计学意义(P>0.05)。心搏骤停至复苏开始时间、复苏开始时间至患者自主循环恢复时间、复苏后有无肌阵挛或抽搐、复苏后血pH值、复苏后72 h体温、复苏后D-二聚体、复苏后第3天APACHEⅡ评分影响两组患者预后,差异均有统计学意义(P<0.05)。多因素Logistic回归分析发现心搏骤停至复苏开始时间、复苏开始时间至患者自主循环恢复时间、复苏后有无肌阵挛或抽搐、复苏后血pH值、复苏后72 h体温、复苏后D-二聚体、复苏后第3天APACHEⅡ评分影响患者心肺复苏自主循环恢复,差异均有统计学意义(P<0.05)。两组患者治疗15 min后,P选择素、E选择素、HIF-2α水平差异无统计学意义(P>0.05);治疗30 min、60 min后,存活组P选择素、E选择素、HIF-2α上升水平均低于死亡组,差异均有统计学意义(P<0.05)。结论影响患者心肺复苏后自主循环患者恢复因素较多,应在抢救患者时,缩短心肺复苏时间,严格遵循10 min内抢救原则,利于患者预后恢复;且预后不良者P选择素、E选择素、HIF-2α水平呈高表达趋势,控制P选择素、E选择素、HIF-2α水平为心肺复苏后续恢复提供治疗方向。Objective To explore the correlation of serum P-selectin,E-selectin and hypoxia inducible factor-2α(HIF-2α)levels within 1 h of resuscitation with the prognosis of patients undergoing return of spontaneous circulation after cardio-pulmonary resuscitation.Methods A sample of 240 patients with return of spontaneous circulation after cardiopulmonary resuscitation in Department of Geriatrics,Changsha Third Hospital from January 2018 to December 2020 were retrospectively enrolled.According to discharge outcome,they were divided into survival group(131 cases)and death group(109 cases).Univariate analysis and multivariate analysis were performed to screen the prognostic indicators affecting cardiopulmonary resuscitation.Serum samples were collected and assayed for P-selectin,E-selectin and HIF-2αwithin 1 h of resuscitation.Then their correlation with the prognosis was discussed.Results Univariate Logistic regression analysis found that gender,age,and underlying medical history had no significant impact on the prognosis of patients(P>0.05).Univariate and Multi factor Logistic regression analysis found that the time from cardiac arrest to the beginning of resuscitation,the time from the beginning of resuscitation to the return of spontaneous circulation,post-resuscitation myoclonus or convulsion,post-resuscitation blood pH value,body temperature at 72 h after resuscitation,post-resuscitation D-dimer,and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score on the 3rd day after resuscitation had significant impact on the prognosis(P<0.05).Levels of P-selectin,E-selectin and HIF-2αyielded no statistically significant difference between two groups at 15 min after treatment(P>0.05);after 30 min and 60 min treatment,the levels of P-selectin,E-selectin and HIF-2αin survival group were relatively lower than those in the death group,the differences were statistically significant(P<0.05).Conclusion The expression levels of P selectin,E selectin,HIF-2αin patients with poor prognosis are high,controling P-selectin,

关 键 词：心肺复苏 自主循环恢复 预后 P选择素 E选择素 HIF-2α 

分 类 号：R459.7[医药卫生—急诊医学]