摘要
目的探讨心肺复苏后患者炎症反应和甲状腺激素的相关性。方法收集2016年1月—2017年8月恢复自主循环后收治入佛山市中医院重症医学科的48例心脏骤停患者的资料,分析患者血清C反应蛋白(CRP)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、游离三碘甲状腺原氨酸(fT3)、游离四碘甲状腺原氨酸(fT4)、促甲状腺激素(TSH)水平与复苏时间(CPR-T)、急性生理学与慢性健康状况评分Ⅱ(APACHE II)的相关性,比较血流动力学不同状态、不同预后间患者炎性因子及甲状腺激素水平的差异,采用多元Logistic回归分析心肺复苏患者预后的影响因素,并分析炎性因子和fT3的相关性。结果48例心肺复苏后患者fT3均低于正常值,CRP、IL-6、IL-8、TNF-α均高于正常值(P<0.05)。fT3水平与CPR-T、APACHE II呈负相关,CRP、IL-6、IL-8、TNF-α和CPR-T、APACHE II呈正相关(P<0.05),fT4、TSH水平与CPR-T、APACHE II无相关性(P>0.05)。血流动力学稳定组fT3水平高于维持组,而CRP、IL-6、IL-8、TNF-α、CPR-T及APACHE II小于维持组,差异有统计学意义(P<0.05)。死亡组的fT3低于预后不良组和预后良好组(P<0.05),CRP、IL-6、IL-8、TNF-α水平高于预后良好和预后不良患者(P<0.05),3组fT4、TSH差异无统计学意义(P>0.05)。Logistic回归分析显示,APACHEⅡ评分、CRP、IL-6、IL-8、TNF-α、fT3和预后有良好相关性(P<0.05)。心肺复苏患者CRP、IL-6、IL-8、TNF-α和ft3均呈负相关(P<0.05)。结论心肺复苏后患者伴明显的炎症反应及fT3水平降低,监测此类指标可以预测患者的预后。
ObjectiveTo analyze the correlation between inflammatory response and thyroid hormone in patients after cardiopulmonary resuscitation(CPR).Methods48 cases of cardiac arrest with return of spontaneous circulation were collected from January 2016 to August 2017 in intensive care unit.The serum CRP,IL-6,IL-8,TNF-α,fT3 and fT4,TSH level was detected.Correlation was analyzed between the above biomarkers and CPR time(CPR-T)and APACHE II score,different prognostic inflammatory factors and thyroid hormone levels were compared between groups with different hemodynamic states.Multivariate Logistic regression was used to analyze the prognostic factors in these patients.Correlation was analyzed between inflammatory factors and fT3.ResultsfT3 was lower than normal in 48 patients after cardiopulmonary resuscitation,and CRP,IL-6,IL-8 and TNF-αwere significantly higher than normal values(P<0.05).fT3 levels were significantly negatively correlated with CPR-T and APACHE II,and CRP,IL-6,IL-8,TNF-α,CPR-T and APACHE II were significantly positively correlated(P<0.05).ft4 and TSH levels were not associated with CPR-T and APACHE II(P>0.05).The level of fT3 in the hemodynamic stable group was higher than that of the maintenance group,the CRP,IL-6,IL-8,TNF-α,CPR-T and APACHE II were significantly lesser than that in the maintenance group(P<0.05).For death patients,fT3 were lower,CRP,IL-6,IL-8 and TNF-αwere significantly higher than other patients(P<0.05),but fT4 and TSH were not significantly different among them(P>0.05).Logistic regression analysis showed that there was a good markedly correlation between APACHEII score,CRP,IL-6,IL-8,TNF-α,fT3 and prognosis(P<0.05).There was a negative significant correlation between CRP,IL-6,IL-8,TNF-αand fT3 in patients after cardiopulmonary resuscitation(P<0.05).ConclusionInflammatory reaction was prominent and fT3 was significantly reduced in patients after CPR,Monitoring of these indicators could help predict the outcome of patient.
作者
江皓波
劳美铃
马明远
JIANG Haobo;LAO Meiling;MA Mingyuan(Intensive Care Unit,Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan 528000,China;Deportment of Endocrinoloy,Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan 528000,China)
出处
《新疆医科大学学报》
CAS
2019年第12期1578-1582,共5页
Journal of Xinjiang Medical University
基金
2015年佛山市高校和医院科研基础平台建设项目(2015AG10001)
2016年广东省佛山市医学类科技攻关项目(2016AB002911)
关键词
心肺复苏
炎症反应
甲状腺激素
相关性
cardiopulmonary resuscitation
inflammatory response
thyroid hormone
correlation
