亚低温治疗对心搏骤停复苏后心肌酶cTnI、CK、CK-MB及心功能的影响

Mild hypothermia treatment of cardiac arrest after cardiopulmonary resuscitation in patients with myocardial enzymes CInI,CK、CK-MB and heart function

目的探讨亚低温治疗对心搏骤停后心肺复苏后患者心肌酶cTnI、CK、CK-MB及心功能的影响。方法回顾性分析2008年1月至2011年1月兰州市第一人民医院急诊科收治的心搏骤停的患者30例,经心肺复苏达到自主循环恢复后随机分为亚低温治疗组和常温组,每组15例,监测两组患者心肌酶cTnI、CK、CK-MB及血流动力学指标在入院各时间段的变化。结果随着时间的推移,常温治疗组心肌酶cTnI、CK、CK-MB均有不同程度的升高,且同时出现低血压、血流动力学异常等,而亚低温组在30min内与常温治疗组比较无明显差异,但2h到72h亚低温组血清cTnI、CK、CK-MB明显低于常温组,组间差异均有统计学意义[均P<0.05)]。随着观察时间的延长,亚低温组的血压、血流动力学等指标等明显改善,组间差异有统计学意义(P<0.05)。结论亚低温治疗可以有效降低心搏骤停患者复苏后患者血清的心肌酶cTnI、CK、CK-MB,减少心搏骤停及心肺复苏对心肌的损伤,降低心肌耗氧量,使复苏后的血流动力学指标好转,改善心功能。

Objective To explore therapeutic hypothermia for cardiac arrest after cardiopulmonary resuscitation in patients with peripheral serum inflammatory factor myocardial enzymes cTnI,CK,CK-MB and heart function.Methods A total of 30 patients of successful cardiopulmonary resuscitation from January 2008 to January 2011 were divided into the hypothermia therapy group（n=15 cases） and the routine therapy group（n=15 cases）,the changes of cTnI,CK,CK-MB in each time were determined,hemodynamics were also recorded.Results cTnI,CK,CK-MB in the therapeutic hypothermia gradually increased,also appeared low blood pressure and hemodynamic abnormalities.There no significant difference at 30 min between hypothermia therapy group and the routine therapy group,from 2 hour to 48 hour hypothermia group,cTnI CK,CK-MB hypothermia therapy group were significantly lower than the routine therapy group,（P0.05）.With the observation of prolonged hypothermia group,blood pressure,hemodynamic indexes were improved,the difference between groups was statistically significant（P0.05）.Conclusion Moderate hypothermia can reduce cTnI,CK,CK-MB,reduce myocardial damage,reduce the myocardial oxygen consumption,significantly improve hemodynamic index and heart function.