心搏呼吸骤停行心肺复苏患者血清TNF-α、IL-6、NSE、S-100b、P选择素的变化及其意义

Changes and significance of serum TNF-α,IL-6,NSE,S-100b,P selectin in patients undergoing cardiopulmonary resuscitation after cardiac arrest

目的:探讨心搏呼吸骤停行心肺复苏(CPR)患者血清肿瘤坏死因子-α(TNF-α)、IL-6、神经元特异性烯醇化酶(NSE)、S-100b蛋白、P选择素的变化及其意义。方法:选取我院2014-03—2017-03期间急诊收治的60例CPR患者,收集时间,根据患者48h内循环是否恢复分为A组19例(48h内患者循环恢复)、B组41例(48h循环未恢复),检测两组的血清TNF-α、IL-6、NSE、S-100b、P选择素水平。结果:B组患者在CPR后2、4、12、24h时的血清TNF-α、NSE、S-100b蛋白水平显著高于A组(P<0.05);A组患者在CPR 48h后血清TNF-α、NSE、S-100b蛋白呈显著下降趋势(P<0.05);B组患者在CPR后2、4、12、24h时的血清IL-6、P选择素水平显著高于A组(P<0.05);A组患者在CPR 24h后血清IL-6、P选择素呈显著下降趋势(P<0.05)。结论:动态观察心脏停搏实施CPR患者血清TNF-α、IL-6、NSE、S-100b、P选择素变化水平,对临床患者救治指有一定指导意义。

Objective:To investigate the changes and significance of serum TNF-α,IL-6,NSE,S-100 bprotein and P selectin in patients after cardiac arrest and cardiopulmonary resuscitation(CPR).Method:Sixty patients after CPR admitted to our hospital from emergency department were selected from March 2014 to March 2017.According to whether the patient's internal circulation was recovered within 48 hours,19 patients in group A(circulation recovered within 48 hours)and 41 patients in group B(circulation not recovered in 48 hours)were tested for serum levels of TNF-α,IL-6,NSE,S-100 b,P selectin.Result:The serum levels of TNF-α,NSE and S-100 bin group B were significantly higher than those in group A at 2 h,4 h,12 hand 24 hafter CPR(P<0.05).Serum TNF-α,NSE and S-100 bproteins in group A showed a significant decrease after 48 hours of CPR(P<0.05).The levels of serum IL-6 and P selectin in group B were significantly higher than those in group A at 2 h,4 h,12 hand 24 hafter CPR(P<0.05).Serum IL-6 and P selectin were significantly decreased in group A after 24 hCPR(P<0.05).Conclusion:Dynamic observation of serum TNF-α,IL-6,NSE,S-100 b,P selectin changes in patients after CPR has a certain guiding significance for the treatment of patients after resuscitation.