摘要
目的 研究心搏骤停心肺复苏(CPR)成功患者血清氧化应激因子、髓过氧化物酶(MPO)、胱抑素C(CysC)水平与近期临床预后关系.方法 选取80例心搏骤停CPR成功患者,根据6个月的预后情况分为预后良好组(n=38)和预后不良组(n=42),比较两组血清氧化应激因子[丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]、MPO、Cys C水平,采用logistic回归分析血清MDA、SOD、GSH-Px、MPO、Cys C水平与近期临床预后的相关性,并分析各指标对近期临床预后的预测价值.结果 预后不良组患者CPR成功后平均动脉压(MAP)低于预后良好组(t=2.54,P＜0.05),预后不良组患者CPR成功后30 min、24 h、48 h的血清MDA、MPO、Cys C水平均高于预后良好组(t 分别=5.20、4.46、6.23、6.66、3.47、8.37、9.47、14.39、27.59,P均＜0.05),SOD、GSH-Px 水平均低于预后良好组(t 分别=-11.37、-6.16、-5.60、-12.39、-5.65、-5.19,P均＜0.05).logistic 回归分析显示,CPR后 24 h 血清 MDA、SOD、GSH-Px、MPO、Cys C水平为心搏骤停CPR成功患者近期临床预后不良的危险因素(OR分别=1.55、1.53、1.54、1.59、1.61,P均＜0.05).ROC曲线分析显示,CPR成功后24 h血清MDA、SOD、GSH-Px、MPO、Cys C水平联合预测心搏骤停CPR成功患者近期临床预后不良的灵敏度为96.00％,AUC为0.91,均高于单独检测(Z分别=8.99、18.98、16.13、7.04、12.12,P均＜0.05).结论 血清MDA、SOD、GSH-Px、MPO、Cys C水平是心搏骤停CPR成功患者近期临床预后不良的危险因素,且其水平联合预测心搏骤停CPR成功患者近期临床预后不良的价值较高.
Abstract
Objective To study the relationship between serum oxidative stress factors,myeloperoxidase(MPO)and cystatin C(CysC)levels and short-term prognosis in patients with successful cardiopulmonary resuscitation(CPR)after cardiac arrest.Methods A total of 80 patients with successful CPR after cardiac arrest were selected and divided into good prognosis group(n=38)and poor prognosis group(n=42)according to the prognosis in 6 months.Serum oxidative stress factors[malondialdehyde(MDA),superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)],MPO and Cys C levels were compared between the two groups.The correlation between serum MDA,SOD,GSH-Px,MPO and Cys C levels and clinical short-term prognosis was discussed.The prognostic value of each index was analyzed.Results The MAP in the poor prognosis group after successful CPR was lower than that in the good prognosis group(t=2.54,P＜0.05).Serum MDA,MPO and Cys C levels in the poor prognosis group at 30min,24h and 48h after successful CPR were higher than those in the good prognosis group(t=5.20,4.46,6.23,6.66,3.47,8.37,9.47,14.39,27.59,P＜0.05).The lev-els of SOD and GSH-Px were lower than those in the good prognosis group(t=-1 1.37,-6.16,-5.60,-12.39,-5.65,-5.19,P＜0.05).Logistic regression analysis found that serum MDA,SOD,GSH-Px,MPO and CysC levels at 24h after CPR were risk factors for poor clinical short-term prognosis in patients with successful CPR after cardiac arrest(OR=1.55,1.53,1.54,1.59,1.61,P＜0.05).ROC curve analysis showed that the sensitivity of combination of serum MDA,SOD,GSH-Px,MPO and CysC at 24h after successful CPR for predicting poor clinical short-term prognosis of patients with successful CPR after cardiac arrest was 96.00％,and the AUC was 0.91,both of which were higher than those of prediction with single index(Z=8.99,18.98,16.13,7.04,12.12,P＜0.05).Conclusion Serum MD A,SOD,GSH-Px,MPO and Cys C levels are risk factors for poor clinical short-term prognosis in patients with suc-cessful CPR after cardiac arrest.Combination of these indexes is of high value in predicting poor clinical short-term prog-nosis of patients with successful CPR after cardiac arrest.
维普
万方数据