血液学指标在评估心肺复苏成功患者预后中的临床价值

摘要

目的:探索血液学指标在评估心肺复苏(cardiopulmonary resuscitation,CPR)成功患者预后的诊断价值.方法:分析我院成功获得CPR的84例老年心脏骤停患者的临床资料,依据患者在CPR成功后是否发生复苏后综合征(post resuscitation syndrome,PRS)分为观察组(发生,n=43)及对照组(未发生,n=41).检测两组患者CPR成功后24~48 h外周血白介素-6(IL-6)、B型钠尿肽(BNP)与肌钙蛋白Ⅰ(TNI)水平,并分析以上指标对CPR后综合征发生的预测诊断价值.结果:观察组患者血清IL-6、BNP及TNI水平均显著高于对照组,均具有统计学意义(P<0.05).ROC曲线分析显示,以35.96 ng/L为截点值,IL-6对CPR发生的预测诊断敏感性为83.72%,特异性为82.93%,曲线下面积为0.83,优于BNP及TNI.观察组患者外周血IL-6水平与BNP(r=0.493,P<0.01)及TNI(r=0.484,P<0.01)均呈现显著正相关关系,均具有统计学意义(P<0.05).结论:IL-6水平对获得CPR成功患者的预后具有一定预测诊断价值,值得临床推广.%Objective:To explore the diagnostic value of haematological index in estimating prognosisfor of patients after successful cardiopulmonary resuscitation(CPR).Methods:84 patients undergoing cardiac arrest in our hospital were selected,and divided into the observation group (n=43,yes) and the control group (n=41,no) according to whether suffer from post resuscitation syndrome(PRS).The levels of Interleukin-6(IL-6),B-type natriuretic peptide(BNP),Troponin Ⅰ(TNI) and after successful CPR with 24~48 h in the patients of the two groups were detected,and the diagnostic value of haematological index in estimating CPR was analyzed.Results:The levels of IL-6,BNP and TNI in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).ROC analysis showed that the IL-6 cut-off point value of 35.96ng/L,as used for post CPR syndrome,provided a sensitivity of 83.72%,a specificity of 82.93%,an Area under the curve of 0.83,better than these of BNP and TNI.Correlation analysis showed that,for the patients in the observation group,the levels of IL-6 had significant positive correlation with BNP(r=0.493,P<0.01) and TNI (r=0.484,P<0.01),all had statistical significance.Conclusion:IL-6 can be used as a marker to estimating in estimating prognosisfor of patients after successful CPR,be worthy of clinical promotion.