| 参附注射液对心脏骤停患者脑复苏后血清NSE和S-100B蛋白水平及预后的影响 |
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| 引用本文： | 费敏,张美齐,郑悦亮,涂建锋,许秋然.参附注射液对心脏骤停患者脑复苏后血清NSE和S-100B蛋白水平及预后的影响[J].中华全科医学,2017,15(3):384. |
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| 作者姓名： | 费敏 张美齐 郑悦亮 涂建锋 许秋然 |
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| 作者单位： | 浙江省人民医院急诊科, 浙江 杭州 310014 |
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| 基金项目： | 2016年度浙江省中医药科学研究基金项目(2016ZA-027) |
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| 摘 要： | 目的 探讨参附注射液治疗心脏骤停(cardiac arrest,CA)患者脑复苏后血清神经元特异性烯醇化酶(NSE)和S-100B蛋白的变化,评价其对预后的影响。 方法 将106例浙江省人民医院收治的心脏骤停后出现自主循环恢复的患者分为2组,每组53例。对照组采用常规脑复苏治疗,保持机体低亚温。治疗组在对照组基础上,给予参附注射液治疗。于心肺复苏后0.5、2、12、24 h,采用酶联免疫吸附法检测2组患者血清NSE和S-100B蛋白的水平。于心脏骤停后12、24、48、72 h检测2组患者脑氧代谢指标水平;采用格拉斯哥昏迷量表(GCS)评估患者昏迷状态。记录2组患者复苏有效率及病死率。 结果 心肺复苏后,2组NSE、S-100B蛋白的水平均显著升高(P<0.05);心肺复苏后2、12、24 h,治疗组NSE、S-100B蛋白的水平均显著低于对照组同期的水平,差异有统计学意义(P<0.05);心脏骤停后12、24、48、72 h,2组患者动静脉血氧含量差(Ca-jvO2)、脑氧摄取率(CERO2)显著降低,颈静脉球部血氧饱和度(SjvO2)、GCS评分显著升高(P<0.05);心脏骤停后48、72 h,治疗组Ca-jvO2、CERO2、GCS评分显著高于对照组同期的水平,SjvO2显著低于对照组同期的水平,差异有统计学意义(P<0.05);治疗组有效率(67.92%)显著高于对照组(45.28%),病死率(69.81%)显著低于对照组(88.68%),差异有统计学意义(χ2=5.530、5.736,P<0.05)。 结论 参附注射液能使心脏骤停患者脑复苏后的血清NSE、S-100B显著降低,有助于改善患者预后。
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| 关 键 词： | 参附注射液 心脏骤停 心肺复苏 NSE S-100B蛋白 |
| 收稿时间： | 2016-09-13 |
Effects of Shen Fu Injection on serum levels of NSE and S-100B protein and prognosis in patients with cardiac arrest after cerebral resuscitation |
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| Affiliation: | Emergency Department, Zhejiang Province People's Hospital, Hangzhou, Zhejiang 310014, China |
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| Abstract: | Objective To investigate the effect of Shen Fu Injection in the treatment of cardiac arrest (cardiac arrest,CA) in patients with cerebral resuscitation after serum neuron specific enolase (NSE) and S-100B protein,and evaluate its effect on prognosis. Methods One hundred and six cases of patients with spontaneous circulation recovery after cardiac arrest in our hospital were divided into two groups,53 cases in each group.The control group was used conventional cerebral resuscitation,maintain low body heat.On the basis of the control group,the treatment group was treated with Shen Fu injection.0.5,2,12 and 24 hours after cardiopulmonary resuscitation,the serum levels of NSE and S-100B in the two groups were detected by ELISA.12,24,48,72 hours after cardiac arrest,the changes of cerebral oxygen metabolism were detected in two groups of patients.Glasgow Coma Scale (GCS) was used to assess coma status.The recovery rate and mortality rate of the two groups were recorded. Results After cardiopulmonary resuscitation,the levels of NSE and S-100B were significantly increased in the two groups (P<0.05).The levels of NSE and S-100B in the treatment group were significantly lower than those in the control group at 2,12 hours and 24 hours after cardiopulmonary resuscitation.The difference was statistically significant (P<0.05).12,24,48 and 72 hours after cardiac arrest,two patients with arteriovenous oxygen content difference (Ca-jvO2),cerebral oxygen uptake rate (CERO2) decreased significantly,jugular bulb oxygen saturation (SjvO2),GCS score increased significantly (P<0.05).Ca-jvO2,CERO2 and GCS scores of the treatment group were significantly higher than those in the control group at 48 hours and 72 hours after cardiac arrest.SjvO2 was significantly lower than that in the control group.The difference was statistically significant (P<0.05).The effective rate (67.92%) in treatment group was significantly higher than that in control group (45.28%),and mortality (69.81%) was significantly lower than that in control group (88.68%).The difference was statistically significant (χ2=5.530,5.736,P<0.05). Conclusion The serum levels of NSE and S-100B in patients with cardiac arrest after cerebral resuscitation can be decreased significantly by the injection of Shen Fu injection,which is helpful to improve the prognosis of patients. |
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