急诊心肺复苏病人血管紧张肽Ⅱ的改变及意义

Meaning of the angiotensinⅡ change in Emergency patients with cardiopulmonary resuscitation

目的探讨心肺复苏后病人血管紧张肽Ⅱ(AngⅡ)的变化及其意义。方法①对84例危重病人分为急诊心肺复苏组(A组,41例)和非心肺复苏组(B组,43例),另设正常对照组(C组,35例)。②A、B组病人于住院后第1、3、5和7天晨7∶30测定AngⅡ的浓度(C组仅做一次),同时记录平均动脉血压和发生心律失常等情况。结果①A、B组的AngⅡ均显著高于C组(P<0.01),而A组更高于B组(P<0.01)。②死亡病人不同时期AngⅡ明显高于存活者(P<0.01),而平均动脉血压均显著低于存活者(P<0.05或P<0.01)。③死亡者不同时期发生快速型室上性、室性心律失常均比存活者显著增多(P<0.05或P<0.01)。结论心跳呼吸骤停心肺复苏后病人体内始终存在AngⅡ升高,且微循环严重障碍,易发生再灌注心律失常,病情严重,预后差。AngⅡ可作为评估心肺复苏后病人预后的有效指标。

Objective To explore the meaning of the angiotensin Ⅱ （Ang Ⅱ ） change in patients with cardiopulmonary resuscitation （CPR）. Methods （1） 84 critical patients were divided into different groups（ Group A,41 emergency patients with CPR; Group B,43 criticall patients without CPR） and 35 normal people（ Group C） were selected for comparism. （2）Observed the changes of the Ang Ⅱ , mean blood pressure（MBP） and arrhythmia in group A and group B on 1,3,5 and 7 days after admission. Plasma levels of AngⅡ in 35 normal people were measured only. Result （1） On 1,3,5and 7 days after admission, plasma levels af AngⅡ in group A and B patients were significantly higher than those in group C （ P 〈0.01）, and AngⅡ in group A were markedly higher than that in group B （ P 〈0.01）. （2） On defferent period, the AngⅡ in death patients were significantly higher than those in survival persons（ P 〈 0.01）; but MBP in death patients were conspicuously lower than those in survival persons（ P 〈 0.05 or P 〈 0.01 ）. （3） On defferent period, higher incidences of supraventricular and ventricnlar tachyarrhythmia in death patients were significantly higher than those in survival patients （ P 〈 0. 05 or P 〈 0. 01 ）. Conclusions. Plasma level of Ang Ⅱ after successful CPR is always very high, and microcircnlation is failure, easily lake place repeffusion arrhythmia. Ang Ⅱ may be used to evaluate prognosis of eardiopulmonary resuscitation patients.