心肺复苏后患者血清抗脑抗体水平的变化及其意义

Change and significance of serum anti-brain antibodies in cardiopulmonary resuscitation patients

目的 研究心肺复苏后患者血清抗脑抗体水平变化及其意义.方法 将27例心脏骤停后心肺复苏成功并存活12周以上的患者根据第12周时格拉斯哥昏迷量表（GCS）评分,将其分为轻中型组12例（GCS评分≥8分）及重型组（GCS评分≤7分）15例.比较两组患者在自主循环恢复（ROSC）后第3,7天和第2,3,4,12周时的血清抗脑抗体水平,并与对照组（15例同期健康查体人群）进行比较.结果 轻、中型组与重型组患者血清抗脑抗体水平在ROSC后第3,7天和第2,3,4,12周时均显著高于对照组[（1.34±0.23）,（1.30 ±0.27） kU/L比（0.28±0.05）kU/L,（1.38±0.33）,（1.44±0.30） kU/L比（0.28±0.05） kU/L,（1.44±0.31）,（1.51±0.33） kU/L比（0.28±0.05） kU/L,（1.53±0.27）,（1.67±0.36） kU/L比（0.28±0.05） kU/L,（1.72±0.25）,（1.93±0.44） kU/L比（0.28±0.05） kU/L,（1.98±0.45）,（2.15±0.52） kU/L比（0.28±0.05） kU/L],差异有统计学意义（P＜0.01）;重型组患者血清抗脑抗体水平在各时间点均明显高于轻、中型组,差异有统计学意义（P＜0.05）.结论 心肺复苏后患者血清抗脑抗体水平明显升高;血清抗脑抗体水平对心肺复苏后患者的脑功能损伤程度和预后有判断价值.

Objective To observe the change of serum anti-brain antibodies after cardiopulmonary resuscitation,and investigate the clinical significance.Methods A total of 27 cases of cardiopulmonary resuscitation after cardiac arrest patients with success and survival more than 12 weeks were divided into two groups according to Glasgow Coma Scale （GCS） score：mild and moderate group with GCS score ≥ 8 scores （12 cases） and severe group with GCS score≤7 scores （15 cases）.The serum anti-brain antibody levels at 3,7 days and 2,3,4,12 weeks after recovered in the spontaneous circulation （ROSC） was compared between two groups,and compared with control group （15 cases of healthy persons）.Results The serum anti-brain antibody levels at 3,7 days and 2,3,4,12 weeks after ROSC were significantly higher than those in control group [（1.34 ± 0.23）,（1.30 ± 0.27） kU/L vs.（0.28 ± 0.05） kU/L,（1.38 ± 0.33）,（1.44 ± 0.30） kU/L vs.（0.28 ±0.05） kU/L,（1.44 ±0.31）,（1.51 ±0.33） kU/L vs.（0.28 ±0.05） kU/L,（1.53 ±0.27）,（1.67 ±0.36） kU/L vs.（0.28 ±0.05） kU/L,（1.72 ±0.25）,（1.93 ±0.44） kU/L vs.（0.28 ±0.05） kU/L,（1.98 ±0.45）,（2.15 ±0.52） kU/L vs.（0.28 ±0.05） kU/L],and there were significant differences （P＜ 0.01）.The serum anti-brain antibody levels in severe group were significantly higher than those in mild and moderate group,and there were significnat differences （P ＜ 0.05）.Conclusions The serum anti-brain antibody levels after cardiopulmonary resuscitation rise significantly.Anti-brain antibody may be used as a biochemistry marker to judge degree and prognosis of brain injury with patients after cardiopulmonary resuscitation.