早期白细胞及降钙素原对非感染性心搏骤停预后的判断价值

Value of leukocyte and procalcitonin on the prognosis of cardiac arrest due to acute noninfectious diseases in the early stage

目的:探索早期白细胞及降钙素原水平对急性非感染性疾病所致心搏骤停的预后判断价值。方法:选择2016年11月—2019年5月本院收治的心搏骤停后经心肺复苏自主循环恢复的急性、非感染性患者46例,按照心搏骤停后30 d是否存活分为2组,分析心搏骤停后患者白细胞及降钙素原水平变化与患者预后的相关性。结果:①两组之间48 h内白细胞及降钙素原水平没有统计学差异;②死亡组白细胞在心搏骤停后即开始出现显著增高,在48 h内下降;③死亡组降钙素原水平在心搏骤停后24 h左右达峰。结论:心搏骤停后患者的白细胞及降钙素原均出现显著增高,心搏骤停48 h内白细胞出现较大增幅的患者可能提示不良预后,早期降钙素原水平及其增长幅度未能预测患者的30 d内死亡风险。

Objective:This study aims to study the value of leukocyte and procalcitonin on the prognosis of cardiac arrest caused by acute non-infectious diseases in the early stage. Methods:Forty-six patients with cardiac arrest admitted to our hospital from November 2016 to May 2019,who returned to spontaneous circulation by cardiopulmonary resuscitation(CPR)without acute infectious diseases,were selected. They were divided into two groups according to the survival at 30 d after cardiac arrest or not. The correlation between the prognosis and the changes of leukocyte and procalcitonin after cardiac arrest was analyzed statistically. Results:①There was significant difference in the levels of leukocyte and procalcitonin between the two groups in the initial 48 hours after cardiac arrest;② For the death group,the level of leukocyte increased immediately after cardiac arrest,reached the peak around 24 h and decreased in 48 h;③The level of procalcitonin of the death group also increased to the peak about 24 h after cardiac arrest. Conclusion:The level of leukocyte and procalcitonin increased significantly after cardiac arrest. The large increase of leukocyte in 24 h after cardiac arrest may indicate a poor prognosis. However,the procalcitonin level in the early stage and its increase cannot predict the death risk of patients within 30 days after cardiac arrest.