CAJ | 학술논문

目的：探讨心肺复苏后血清脑钠肽水平对脑损伤的预测价值。方法选择2008年1月至2013年1月在海口市人民医院进行心肺复苏的68例患者为研究对象，根据脑损伤程度将患者分为轻度脑损伤组（28例）、中度脑损伤组（20例）及重度脑损伤组（20例），选择同期进行健康体检的28例健康者作为对照组。比较对照组研究对象和3组患者在自主循环回复后2、8、12、24及48 h血清脑钠肽的水平，分析不同时间脑钠肽的水平与格拉斯哥昏迷评分（ GCS）的相关性。结果4组研究对象血清脑钠肽的水平在组间、不同时点间及组间·不同时点间交互作用比较差异均有统计学意义（P＜0.05），其中重度脑损伤组患者的脑钠肽最高，2、8、12、24、48 h分别为（3.26±0.14） ng／L、（3.34±0.57） ng／L、（3.13±0.39） ng／L、（2.99±0.41） ng／L、（2.15±0.13） ng／L，对照组最低，分别为（0.75±0.44） ng／L、（0.75±0.44） ng／L、（0.78±0.44） ng／L、（0.75±0.45） ng／L、（0.75±0.44） ng／L，且不同时点间脑钠肽水平与GCS呈负相关（P＜0.05）。结论心肺复苏后患者血清脑钠肽的水平可预测脑损伤程度，脑钠肽水平越高，脑损伤程度越严重，患者预后越差；反之，则损伤较轻，预后较好。
목적：탐토심폐복소후혈청뇌납태수평대뇌손상적예측개치。방법선택2008년1월지2013년1월재해구시인민의원진행심폐복소적68례환자위연구대상，근거뇌손상정도장환자분위경도뇌손상조（28례）、중도뇌손상조（20례）급중도뇌손상조（20례），선택동기진행건강체검적28례건강자작위대조조。비교대조조연구대상화3조환자재자주순배회복후2、8、12、24급48 h혈청뇌납태적수평，분석불동시간뇌납태적수평여격랍사가혼미평분（ GCS）적상관성。결과4조연구대상혈청뇌납태적수평재조간、불동시점간급조간·불동시점간교호작용비교차이균유통계학의의（P＜0.05），기중중도뇌손상조환자적뇌납태최고，2、8、12、24、48 h분별위（3.26±0.14） ng／L、（3.34±0.57） ng／L、（3.13±0.39） ng／L、（2.99±0.41） ng／L、（2.15±0.13） ng／L，대조조최저，분별위（0.75±0.44） ng／L、（0.75±0.44） ng／L、（0.78±0.44） ng／L、（0.75±0.45） ng／L、（0.75±0.44） ng／L，차불동시점간뇌납태수평여GCS정부상관（P＜0.05）。결론심폐복소후환자혈청뇌납태적수평가예측뇌손상정도，뇌납태수평월고，뇌손상정도월엄중，환자예후월차；반지，칙손상교경，예후교호。
Objective To explore the predictive value of serum brain natriuretic peptide ( BNP) level on brain injury after cardiopulmonary resuscitation.Methods Sixty-eight patients who received cardiopulmo-nary resuscitation in Haikou City People′s Hospital from Jan.2008 to Jan.2013 were selected as the research objects.According to the degrees of brain injury,the patients were divided into mild brain injury group(28 cases),moderate brain injury group(20 cases) and severe brain injury group(20 cases).Another 28 healthy people who took health examination at same period were included as control group .The serum BNP levels at 2,8,12,24 and 48 h after cardiopulmonary resuscitation of the three groups and the control group were com-pared,and the correlation between BNP level at different time pointes with Glasgow coma score ( GCS) was analyzed.Results The serum BNP levels of the 4 groups between different groups,different time points and groups· different time points were statistically significantly different ( P <0.05 ) , the serum BNP level of severe brain injury group was the highest,the level of 2,8,12,24,48 h were (3.26 ±0.14) ng/L,(3.34 ± 0.57) ng/L,(3.13 ±0.39) ng/L,(2.99 ±0.41) ng/L,(2.15 ±0.13) ng/L respectively;the serum BNP level of the control group was the lowest,they were (0.75 ±0.44) ng/L,(0.75 ±0.44) ng/L,(0.78 ± 0.44) ng/L,(0.75 ±0.45) ng/L,(0.75 ±0.44) ng/L respectively;there was negative correlation between BNP level and GCS (P<0.05) at different time points.Conclusion Serum BNP level after cardiopulmonary resuscitation can be used to predict the degrees of brain injury:the higher the serum BNP level,the worse the brain injurythe poorer the prognosis;on the other hand,the the injury is mild and the prognosis is good.