心搏骤停者早期皮质醇的变化及临床意义

Changes and clinical significance of cortisol level in early stage of cardiac arrest

皮质醇绝对或相对不足广泛存在于各种危重病中,包括心搏骤停(cardiac arrest,CA)。2008年美国危重病医学会(SCCM)首次提出危重症相关性肾上腺皮质功能不全(critical illness-related corticosteroid insufficiency,CIRCI)的概念,描述了危重病急性应激反应时下丘脑-垂体-肾上腺(HPA)轴功能障碍。研究表明CA患者皮质醇的变化会影响患者预后.

There is abnormal adrenocortical function in the early stage of treatment for patients with cardiac arrest,and the level of cortisol is related with the prognosis of the patients.The activation of the hypothalamic-pituitary-adrenal axis by cardiac arrest and the initiation of an ischemic injury of the HPA axis may be the major causes of the change in cortisol during cardiac arrest.Studies indicated that the application of exogenous glucocorticoid may improve the restoration of spontaneous circulation and long-term survival rate.However,the role of glucocorticoids in cardiopulmonary resuscitation is still controversial,especially in prognosis of neural function.