脑尿钠肽对心肺复苏患者预后的临床意义

Study on the Clinical Significance of B-type Natriuretic Peptide Level To the Prognosis of Cardiopulmonary Resuscitation

目的探讨外周静脉血脑尿钠肽(B-type natriureitic peptide,BNP)与心肺复苏(Cardiopulmonary Resuscitation,CPR)预后的关系。方法 98例心脏骤停的CPR患者,根据复苏效果分为A组(42例):CPR 0.5h无效死亡。B组(21例):CPR成功,自主循环恢复(recovery of spontaneous circulation,ROSC)≥24h,但在24h后本次住院内死亡。C组(35例):CPR成功,本次康复出院。D组(20例):对照组,为20例健康体检者。CPR即刻0h、0.5h、4h、8h、12h及24h分别抽取外周静脉血2m L,对照组早晨空腹抽取外周血2m L,测定全血BNP含量。比较各组患者该指标的动态变化。结果CPR即刻0h:A、B和C三组患者BNP均值水平高,与D组比较,差异有统计学意义(P<0.05)。B组0h^24h BNP表达持续上升,C组在0h^8h BNP表达持续上升到顶点,8h^24h BNP表达逐渐下降。结论 CPR过程中,BNP的表达呈动态变化,BNP的大量表达提示预后不良。

Objective To explore the prognostic value of BNP in patients with CPR. Methods A total of 98 patients with sudden cardiac arrest were divided into 3 groups according to the effect of Cardiopulmonary Resuscitation. 42 patients were all died in group A after CPR for half an hour. 21 patients in group B were all died during this hospitalization after the return of spon-taneous circulation for 24 hours. 35 patients in group C were all survival to hospital discharge. Group D, ased the control group, were composed of 20 healthy peoples. In group A, B, and/C, peripheral venous blood（2ml）were taken to measure the BNP con-centration at the time of 0h、0. 5h、4h、8h、12h and 24h after CPR Blood samples（2ml） of the control group were taken at early morning on an empty stomachall. Results Compared with control group D, the BNP level in Group A, B and C were all statisti-cally significant higher（P〈0. 05）at the time of 0h. The BNP level in Group B expressed continuing ascending during 24h. The BNP level in Group C expressed continuing ascending and reached the peak at 8h, then declined gradually during 8~24h. Con-clusion During CPR, the expression of BNP showed dynamic changes. Higher BNP level indicateed poor prognosis.