脑钠肽与心肺复苏后脑损伤预后的相关性研究

摘要

目的 探讨心肺复苏后血脑钠肽(brain natriuretic peptide,BNP)浓度的变化与脑损伤的相关性.方法 选择2009年3月-2011年2月在我院复苏成功的心搏呼吸骤停后继续脑复苏患者20例,以格拉斯哥昏迷评分分为A、B、C 3组,分别检测3组BNP的浓度,并比较心跳骤停即刻、复苏成功后即刻及6、24、48、72h BNP浓度的变化情况.结果 心跳骤停初期,BNP水平升高.随着心肺复苏成功进行,自主循环的建立和应激过程的减弱,BNP逐渐降低.心跳骤停初期BNP的增高水平及复苏后BNP的持续高水平与心肺复苏后脑损伤的预后呈负相关(r=-0.88,P＜0.01).A、B、C 3组各组之间的BNP水平差异有统计学意义(P＜0.05或P＜0.01).结论 BNP水平的监测既能反映心肺复苏(cardiopulmonary resuscitation,CPR)后脑损伤的严重程度,又可以预测CPR后的意识恢复情况,对CPR后脑复苏的评估有重要的价值.%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 CPl. It has important value in the assessment of brain recovery after CPR.