腦鈉肽與心肺復(fù)蘇后腦損傷預(yù)后的相關(guān)性研究

摘要： 目的探討心肺復(fù)蘇后血腦鈉肽(brain natriuretic peptide,BNP)濃度的變化與腦損傷的相關(guān)性。方法選擇2009年3月—2011年2月在我院復(fù)蘇成功的心搏呼吸驟停后繼續(xù)腦復(fù)蘇患者20例,以格拉斯哥昏迷評(píng)分分為A、B、C 3組,分別檢測(cè)3組BNP的濃度,并比較心跳驟停即刻、復(fù)蘇成功后即刻及6、24、48、72h BNP濃度的變化情況。結(jié)果心跳驟停初期,BNP水平升高。隨著心肺復(fù)蘇成功進(jìn)行,自主循環(huán)的建立和應(yīng)激過程的減弱,BNP逐漸降低。心跳驟停初期BNP的增高水平及復(fù)蘇后BNP的持續(xù)高水平與心肺復(fù)蘇后腦損傷的預(yù)后呈負(fù)相關(guān)(r=-0.88,P<0.01)。A、B、C3組各組之間的BNF水平差異有統(tǒng)計(jì)學(xué)意義(P<0.05或P<0.01)。結(jié)論 BNP水平的監(jiān)測(cè)既能反映心肺復(fù)蘇(cardiopulmonary resuscitation,CPR)后腦損傷的嚴(yán)重程度,又可以預(yù)測(cè)CPR后的意識(shí)恢復(fù)情況,對(duì)CPR后腦復(fù)蘇的評(píng)估有重要的價(jià)值。
Objective To investigate the correlation of brain natriuretic peptide (BNP) with brain damage after cardiopulmonary resuscitation (CPR).Methods Twenty patients after successful resuscitation of cardiac respiratory arrest from Mar.2009 to Feb.2011 were selected.According to GCS scores,all the patients were divided into 3 groups,group A,group B and group C.BNP concentration were measured and compared cardiac arrest immediately,immediately after resuscitation and 6,24,48,72h after resuscitation.Results BNP levels increased in the initial cardiac arrest.With the success of cardiopulmonary resuscitation,the establishment of spontaneous circulation process and reduced stress, BNP levels were gradually returned.There was a negative correlation between increased level of BNP in the initial cardiac arrest,the sustained high level of BNP after resuscitation,and the prognosis of brain injury after cardiopulmonary reswscitation.The levels of BNP among the 3 groups were significantly different (P<0.05 or P<0.01).Conclusion BNP monitor can reflect the severity of brain injury after CPR,also can predict the recovery of consciousness recovery after CPR.It has important value in the assessment of brain recovery after CPR.