摘要
目的探究心肺复苏(CPR)患者血浆中B型利钠肽(BNP)、D-二聚体(D-D)水平与患者预后的关系。方法选取2014年1月至2019年6月本院收治的心脏骤停CPR成功患者98例作为研究对象,根据CPR后不同时间血浆BNP水平分为A、B、C三组,A组27例,B组34例,C组37例。收集患者一般资料进行比较;采用化学发光免疫分析检测血浆中BNP、全自动凝血分析仪检测血浆中D-D水平;分析血浆BNP、D-D水平与患者死亡率的关系;绘制三组患者6个月Kaplan-Meier生存曲线;Cox回归分析影响患者死亡的因素。结果三组一般情况比较差异无统计学意义(P>0.05),具有可比性;CPR成功后3 h,B组、C组D-D水平均明显高于A组(P<0.05),CPR成功后12~24 h,B组、C组D-D水平均明显高于A组(P<0.05),C组D-D水平明显低于B组(P<0.05),三组CPR成功后D-D水平均呈上升趋势,B组CPR成功后12~24 h D-D水平高于CPR成功后3 h(P<0.05),A组、C组CPR成功后12~24 h D-D水平低于CPR成功后3 h(P<0.05);BNP、D-D高表达组患者死亡率均高于BNP、D-D低表达组(P<0.05);A组、C组患者6个月生存率均明显高于B组(P<0.05),A组患者6个月生存率与C组患者比较差异无统计学意义(P>0.445);Cox回归分析显示,BNP及D-D水平均是患者死亡的独立危险因素。结论血浆BNP、D-D水平在CPR成功后3 h内均有所上升,部分患者持续升高,二者的高表达是影响CPR成功患者预后的独立危险因素,或可成为预测CPR成功患者预后的生物标志物。
Objective To explore the relationships between the levels of B-type natriuretic peptide(BNP), D-dimer(D-D) and the prognosis of patients with cardiopulmonary resuscitation(CPR).Methods 98 cardiac arrest patients with successful CPR in our hospital from January, 2014 to June, 2019 were selected as the study objects. According to the plasma BNP levels at different time points after CPR, they were divided into three groups: group A(27 cases), group B(34 cases), and group C(37 cases). General data of patients were collected and compared;Chemiluminescence immunoassay was used to detect the levels of BNP in plasma, and automatic coagulation analyzer was used to detect D-D levels in plasma;Also, the relationships between BNP, D-D and mortality were analyzed;The six-month Kaplan Meier survival curve was drawn, and Cox regression analysis was used to analyze the factors affecting the death of patients.Results There was no significant difference among the three groups(P>0.05).3 hours after CPR,D-D levels in groups B and C were significantly higher than those in group A(P<0.05), and 12-24 hours after CPR, D-D levels in groups B and C were significantly higher than those in group A(P<0.05), furthermore, D-D levels in group C were significantly lower than those in group B(P<0.05).The D-D levels of the three groups all increased after CPR,and D-D levels in group B at 12-24 hours after CPR were higher than those at 3 hours after CPR(P<0.05),also, D-D levels in group A and group C at 12-24 hours after CPR were lower than those at 3 hours after CPR(P<0.05). The mortality of BNP and D-D high expression groups was higher than that of BNP and D-D low expression groups(P<0.05). The 6-month survival rate of group A and group C was significantly higher than that of group B(P<0.05), while there was no significant difference between group A and group C(P>0.445). Cox regression analysis showed that BNP level and D-D level were independent risk factors of death.Conclusion The levels of BNP and D-D in plasma are increased within 3 hours after CPR, and some patients continued to rise. The high expressions of these two markers are independent risk factors for the prognosis of patients with successful CPR, which can be biomarkers to predict the prognosis of patients with successful CPR.
作者
刘光明
殷旭升
LIU Guangming;YIN Xusheng(Department of Critical Care Medicine,Zhongshan Hospital,Guangdong Medical University,(Formerly ZhongshanChen Xinghai Hospital)Zhongshan 528415,China)
出处
《标记免疫分析与临床》
CAS
2020年第7期1193-1197,共5页
Labeled Immunoassays and Clinical Medicine
关键词
心肺复苏
B型钠尿肽
D-二聚体
预后相关性
Cardiopulmonary resuscitation
B-type natriuretic peptide
D-dimer
Prognostic correlation
