CAJ | 학술논문

目的探讨心搏骤停复苏(CPR)后患者血清细胞因子的动态变化及其临床意义.方法将27例CPR自主循环(ROSC)还真分为复苏失败组(A1)19例和存活出院组(A2)8例,22例死亡者做对照组(B),用ELISA法动态检测CPR时、24、48、72 h、7 d患者血清IL-4、IL-8、IL-10、IL-8水平变化.结果 B组CPR时TNF-α含量高于A1组、A2组(P<0.05),IL-1β、IL-4、IL-8、IL-10水平三组之间差异无统计学意义(P>0.05).A1组复苏后多脏器功能衰竭发病高于A2组(14/19,2/8,P<0.05),ROSC 24 h TNF-α水平高于其CPR时和A2组(P<0.05),ROSC 48 h TNF-α、IL-8水平达峰值,且高于A2组,IL-4、IL-10水平高于其CPR时(P<0.05),与A2组相比差异无统计学意义(P>0.05),ROSC 72 h TNF-α水平下降,IL-4高于A2组(P<0.05).结论细胞因子异常释放参与复苏后缺血-再灌注损伤病理过程,选择时机干预其失衡,提高复苏存活率,改善预后.
목적 탐토심박취정복소(CPR)후환자혈청세포인자적동태변화급기림상의의.방법 장27례CPR자주순배(ROSC)환진분위복소실패조(A1)19례화존활출원조(A2)8례,22례사망자주대조조(B),용ELISA법동태검측CPR시、24、48、72 h、7 d환자혈청IL-4、IL-8、IL-10、IL-8수평변화.결과 B조CPR시TNF-α함량고우A1조、A2조(P<0.05),IL-1β、IL-4、IL-8、IL-10수평삼조지간차이무통계학의의(P>0.05).A1조복소후다장기공능쇠갈발병고우A2조(14/19,2/8,P<0.05),ROSC 24 h TNF-α수평고우기CPR시화A2조(P<0.05),ROSC 48 h TNF-α、IL-8수평체봉치,차고우A2조,IL-4、IL-10수평고우기CPR시(P<0.05),여A2조상비차이무통계학의의(P>0.05),ROSC 72 h TNF-α수평하강,IL-4고우A2조(P<0.05).결론 세포인자이상석방삼여복소후결혈-재관주손상병리과정,선택시궤간예기실형,제고복소존활솔,개선예후.
Objective To investigate the dynamic changes and significance of serum cytokines in patients with dif-ferent prognosis after cardiopulmonary resuscitated. Methods The patients undergone CPR were divided into recovers the successful group and anabiesis defeat group. The levels of serum tumor necrosisfactor - α (TNF - α), interleukin - 4 (IL - 4), interleukin - 8 (IL - 8), interleukin - 10 (IL - 10) were measured in 27 patients after CPR with return of spontane-ous circulation(ROSC) by enzyme- linked immunosorbent assay(ELISA). Results In group B,the levels of serum tumor necrosisfactor-α(TNF-α) was increased and significantly higher shah group A1> and A2> at cardiac arrest- before CPR (P > 0.05). There no significant difference of the serum IL-4,IL-8,IL- 10 among the three groups. After group A1> re-covets the MODS disease incidence rate to be higher than group A2> (14/19,2/8, P <0.05). The level of TNF-α in ROSC 24 h was higher than when its CPR and group A2>(P <0.05), ROSC 48 h TNF - TNF - α,the IL -8 level reaches the peak value,also was higher than the group A2> ,level of IL -4 and IL - 10 were higher than when its CPR (P <0. 05), and had no statistics significance compared with group A2>(P >0.05), level of ROSC 72 h TNF-α decrease, IL-4 was higher than group A2. Conclusions The serum eytokines play an important role in the pathogenesis of lacks the blood - to pour into a-gain after. To intervene and maintain the balance of cytokines may be a way to improve the patients prognosis after CPR.