心肺复苏患者NF-κB亚基P65、TNF-α的变化及相关性分析

Changes of NF-κB P65 and the correlation with TNF-α in patients who underwent cardiopulmonary resuscitation

目的分析心肺复苏(cardiopulmonary resuscitation,CPR)患者心脏骤停(cardiac arrest,CA)时及自主循环恢复(restoration of spontaneous circulation,ROSC)后血浆核转录因子kappa B(nuclear factor kappa B,NF-κB)亚基P65、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)浓度的变化,并探讨两者的关系。方法收集行CPR后ROSC并存活≥24 h的CA患者30例,分别于CA时、ROSC即刻和ROSC后2 h、8 h、12 h、24 h测定血浆NF-κB亚基P65、TNF-α水平,并进行相关性分析。结果 CPR患者NF-κB亚基P65在ROSC即刻、2 h、8 h、12 h、24 h均高于CA时(P<0.05),且在12 h达到峰值,TNF-α在ROSC即刻、2 h、8 h、12 h、24 h均高于CA时(P<0.05),在8 h达到峰值,NF-κB亚基P65与TNF-α呈正相关关系(P<0.05)。结论 CA患者CPR后出现炎症反应,NF-κB亚基P65的活化可刺激TNF-α的释放,ROSC后12 h内是心肺复苏救治的关键时期。

Objective To analyze the plasma levels of NF-κB P65 and TNF-αin patients with cardiac arrest(CA)who underwent cardiopulmonary resuscitation(CPR)and had return of spontaneous circulation(ROSC),and investigate the correlation between them.Methods Medical records of 30 patients with CA who underwent CPR and had ROSC and survived more than 24 hours were collected,the plasma levels of NF-κB P65 and TNF-αwere tested at CA,ROSC and 2 h,8 h,12 h,24 h after ROSC,and the correlation was analyzed.Results The plasma levels of NF-κB P65 at ROSC and 2 h,8 h,12 h,24 h after ROSC were higher than CA(P<0.05),and peaked at 12 h after ROSC.the plasma levels of TNF-αat ROSC and 2 h,8 h,12 h,24 h after ROSC were higher than CA(P<0.05),and peaked at 8 h after ROSC.Correlation analysis showed that NF-κB P65 was positively correlated with TNF-α(r=0.492,P<0.05).Conclusion The inflammation occured in patients with CA who underwent CPR,the activation of NF-κB P65 could increase the release of TNF-α,within 12h after ROSC was the critical period in CPR.