缺血修饰蛋白变化对心肺复苏效果的评估

Clinical value of ischemia-modified albumin in prognosis of cardiopulmonary resuscitation

目的研究缺血修饰蛋白（IMA）和丙二醛（MDA）变化对早期评估心肺复苏效果的价值。方法对50名心搏骤停患者及50名健康志愿者进行对照研究。在施行心肺复苏术5min以内采集血液标本，测定IMA、MDA。同时用格拉斯哥预后评分标准对患者预后进行分组评估。结果心肺复苏效果不理想组平均IMA水平为（0．26±0．05）ABSU，高于效果理想组的（0．18±0．07）ABSU（P〈0．05）。也高于对照组（0．16±0．04）ABSU（P〈0．05）。复苏效果理想组与对照组IMA水平差异无统计学意义（P〉0．05）。复苏效果不理想组MDA水平（0．78±0．28）nmol／ml，与复苏效果理想组（0．76±0．18）nmol／ml差异无统计学意义（P〉0．05），但明显高于对照组（O．61±0．11）nmol／ml（P〈0．05）。复苏效果理想组与对照组MDA水平差异无统计学意义（P〉0．05）。结论IMA可以作为心搏骤停患者心肺复苏效果的重要标志。

Objective To investigate the levels of ischemia-modified albumin（IMA） and malondialdehyde （MDA） in CA patients and whether IMA level is valuable early marker of post-cardiopulmonary resuscitation prognosis in CA patients. Methods We enrolled 50 in-or out-of-hospital CA patients ,with 50 healthy volunteers as the control group（CG）. Blood samples were taken for IMA and MDA measurement at the beginning or within 5 min of commencement of CPR. The patients were classified according to the Glasgow Outcome Score（GOS） into a poor outcome group（POG） and a good outcome group（GOG）. Results Mean IMA levels were higher in POG（0. 26 ± 0. 05 ABSU） than in GOG （ 0. 18± 0. 07 ABSU, P 〈 0. 05 ） and also than CG （0. 16 ±0. 04 ABSU, P 〈 0. 05 ）. The IMA level was not significantly higher in GOG than in CG（ P = 0. 32 ）. The mean MDA levels in POG（ 0.78 ± 0. 28 nmol/ml） was comparable to the level in GOG（0. 76 ±0. 18 nmol/ml,P 〉0. 05） ,but was significantly higher than in CG（0. 61 ± 0. 11 nmol/ml ,P 〈 0. 05 ）. MDA level was not significantly higher in GOG than in CG（ P 〉 0. 05 ）. Conclusion In conclusion ,though the results may not be applied clinically in every patient, the iscbemia-modified albumin may be a valuable prognostic marker in cardiac arrest patients following CPR.