心肺复苏成功患者血清HO-1、CD39水平与心功能、主要不良心血管事件的关系  

Relationship between serum HO-1 and CD39 levels and cardiac function and major adverse cardiovascular events in patients with successful cardiopulmonary resuscitation

作　　者：杨思伟 袁圆[2] 宋训君 YANG Siwei;YUAN Yuan;SONG Xunjun(Department of Emergency Medicine,Zigong First People's Hospital,Zigong,Sichuan 643000,China;Department of Family Medicine,Zigong First People's Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第一人民医院急诊医学科,四川自贡643000 [2]自贡市第一人民医院全科医学科,四川自贡643000

出　　处：《国际检验医学杂志》2024年第16期2038-2043,共6页International Journal of Laboratory Medicine

摘　　要：目的探讨心肺复苏成功患者血清血红素加氧酶-1(HO-1)、CD39水平与心功能、主要不良心血管事件(MACE)的关系。方法选取2019年12月至2022年12月自贡市第一人民医院收治的因突发心跳、呼吸骤停进行心肺复苏成功的160例患者作为研究组。对研究组采用美国纽约心脏病学会(NYHA)心功能分级方法进行心功能分组,分为心功能Ⅱ级组、心功能Ⅲ级组、心功能Ⅳ级组。另外选取同期在该院体检的100例体检健康者作为对照组。检测两组血清HO-1、CD39水平。以随访6个月有无发生MACE分为非MACE组91例与MACE组69例。采用受试者工作特征曲线评估血清HO-1、CD39水平对心肺复苏成功患者MACE的预测价值。采用二分类Logistic逐步回归分析探讨心肺复苏成功患者MACE的影响因素。结果研究组血清HO-1、CD39水平高于对照组,差异有统计学意义(P<0.05)。心功能Ⅳ级组血清HO-1、CD39水平均高于心功能Ⅲ级组、心功能Ⅱ级组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,血清HO-1、CD39水平与心肺复苏成功患者NYHA心功能分级呈正相关(r=0.534、0.496,P<0.001)。MACE组血清HO-1、CD39水平高于非MACE组,差异有统计学意义(P<0.05)。血清HO-1、CD39水平预测心肺复苏成功患者发生MACE的曲线下面积(AUC)分别为0.725(95%CI:0.682~0.774)、0.864(95%CI:0.814~0.917),两者联合预测的AUC为0.901(95%CI:0.851~0.946)。非MACE组心搏骤停至复苏时间低于MACE组,左室射血分数(LVEF)高于MACE组,差异有统计学意义(P<0.05)。二分类Logistic逐步回归分析结果显示:LVEF<50%(OR=3.466,95%CI:1.537~7.818)、血清HO-1≥5.13 ng/mL(OR=3.804,95%CI:1.706~8.479)、血清CD39≥29.87%(OR=4.345,95%CI:1.852~10.192)是心肺复苏成功患者发生MACE的危险因素(P<0.05)。结论血清HO-1、CD39水平对心肺复苏成功患者发生MACE具有较高的预测价值。Objective To explore the relationship between serum heme oxygenase-1(HO-1),CD39 levels and cardiac function and major adverse cardiovascular events(MACE)in patients with successful cardiopulmonary resuscitation.Methods A total of 160 patients admitted to the Zigong First People's Hospital from December 2019 to December 2022 who underwent successful cardiopulmonary resuscitation due to sudden heartbeat and respiratory arrest were selected as the study group.The study group was divided into cardiac function gradeⅡgroup,cardiac function gradeⅢgroup and cardiac function gradeⅣgroup using the New York Heart Association(NYHA)cardiac function grading method.In addition,100 healthy subjects who underwent physical examination in the same period were selected as the control group.The levels of serum HO-1 and CD39 in two groups were detected.After 6 months of follow-up,there were 91 cases in non-MACE group and 69 cases in MACE group.The predictive value of serum HO-1 and CD39 levels for MACE in patients with successful cardiopulmonary resuscitation was evaluated by receiver operating characteristic curve.Binary Logistic stepwise regression analysis was used to investigate the influencing factors of MACE in patients with successful cardiopulmonary resuscitation.Results The serum levels of HO-1 and CD39 in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).The levels of serum HO-1 and CD39 in cardiac function gradeⅣgroup were higher than those in cardiac function gradeⅢgroup and cardiac function gradeⅡgroup,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that serum HO-1 and CD39 levels were positively correlated with NYHA cardiac function classification in patients with successful cardiopulmonary resuscitation(r=0.534,0.496,P<0.001).The serum levels of HO-1 and CD39 in MACE group were higher than those in non-MACE group,and the difference was statistically significant(P<0.05).The area under the curve(AUC

关 键 词：血红素加氧酶-1 心肺复苏 心功能 主要不良心血管事件 

分 类 号：R473.5[医药卫生—护理学]