摘要
目的 了解心脏骤停患者经心肺复苏（cardiopulmonary resuscitation,CPR）后血清缺血修饰白蛋白（ischemia modified albumin,IMA）水平变化情况,探讨血清IMA在预测心脏骤停患者CPR预后的应用价值.方法 （1）选择36例（男性25例,女性11例）心脏骤停经CPR的成年住院患者,构成试验（C）组,并根据CPR后是否达到ROSC分为复苏（R）组和未复苏（NR）组,其中R组15例（男性11例,女性4例）,NR组21例（男性14例,女性7例）.同时选择60例（男性39例,女性21例）与C组年龄、性别相一致的健康体检人员,构成健康对照（H）组.（2）测定上述血清的IMA水平,分析各组之间的血清IMA水平差异.结果 （1）C组血清IMA水平高于H组（P＜0.05）;其中NR组血清IMA水平高于R组和H组（均P＜0.05）,R组的血清IMA水平高于H组（P＜0.05）;（2）血清IMA预测心脏骤停患者CPR预后的ROC曲线下面积为0.73;当截断值为128.25 U/mL时,灵敏度=57.1％,特异性为93.3％,阳性预测值为92.3％,阴性预测值为60.9％,阳性似然比为8.5,阴性似然比为0.5,正确诊断指数为72.2％,Youden指数为50.5％.结论 血清IMA在心脏骤停患者CPR预后的预测方面具有一定的价值.
Objective To study the changes in the level of serum IMA in patients with cardiac arrest followed by CPR,and explore the value of serum IMA in predicting prognosis of these patients after CPR.Methods （1） A total of 36 patients （25 men and 11 women） after CPR following cardiac arrest were recruited into experimental group （group C）.Of them,15 cases （11 men and 4 women） and 21 cases （14men and 7 women） were assigned into resuscitation group （group R） and non resuscitation group （group NR）,respectively,according to the presence or absence of ROSC.Meanwhile,another 60 healthy subjects （39 men and 21 women） matched for age and gender were recruited into healthy control group （group H）.（2） The determination of the serum IMA level and comparisons of changes in serum IMA levels among groups were carried out.Results （1） The level of serum IMA in group C was higher than that in group H （P 〈 0.05） ; The serum IMA level in group R was lower than that in group NR and higher than that in group H （P 〈0.05 for both）.（2） The area under the ROC curve for serum IMA in predicting the prognosis of patients treated with CPR after cardiac arrest was 0.73.When the cut off value was 128.25 U/mL,the sensitivity and specificity were 57.1% and 93.3% respectively; the positive predictive value and negative predictive value were 92.3% and 60.9% ; positive likelihood ratio and negative likelihood ratio were 8.5 and 0.5 ; the correct diagnosis index was 72.2%,and Youden index was 50.5%.Conclusions Serum IMA has a certain value in prediction of prognosis in patients treated with CPR following cardiac arrest.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2015年第2期183-187,共5页
Chinese Journal of Emergency Medicine
基金
福建省医学科技创新项目（2011-CX-3）
福建省自然科学基金计划项目（2014J01289）
国家临床重点专科建设项目（2012）
关键词
缺血修饰白蛋白
心脏骤停
心肺复苏
自主循环恢复
预测指标
预后
评价
临床意义
受试者工作特征曲线
Ischemia modified albumin
Cardiac arrest
Cardiopulmonary resuscitation
Restoration of spontaneous circulation
Predict index sign
Prognosis
Evaluation
Clinical significance
Receiver operating characteristic curve
