心肺复苏循环复后淀粉酶改变与预后关系的研究

目的探讨心肺复苏期间血清淀粉酶变化的预后意义。方法对42例进行心肺复苏并一度建立自主循环的心跳骤停患者的血清淀粉酶、血气分析指标和24h生存率进行观察。结果①血清淀粉酶＞400U/L组的24h生存率(16.7％)明显低于＜400U/L组(70.8％,P=0.00055);②血清淀粉酶逐渐增高组的死亡率高于逐渐降低组(P=0.05450);③24h生存组的血清淀粉酶水平为431.3±229.5U/L,低于死亡组(559.0±254.9U/L),2组比较差异接近显著(t=1.865,P＜0.1);④血清淀粉酶＞400U/L组的pH值为7.014±0.228,明显低于＜400U/L组(pH7.137±0.165),差异显著(t=2.031,P＜0.05)。结论心肺复苏期间血清淀粉酶升高,尤其是逐渐增高者,提示预后不良。

Prognosis meaning of the serum amylase change during cardiopulmonary resuscitation

Objective To explore the prognosis meaning of the change of the serum amylase during cardiopulmonary resuscitation (CPR).Methods Observe the changes of the serum amylase, blood gas analysis index and the 24 hours survival rate in 42 cardiac arrest patients who have been treated with CPR and once recovered autonomous circulation. Result ①The survival rate(16.7% )in the group whichserum amylase level ＞ 400 U/L is much higher than that which serum amylase level ＜ 400 U/L(70.8%, P = 0.00055) ;②The group which serum amylase level gradually rise has higher dead rate than that of serum amylase gradually dropped ( P = 0.0545) ;③The mean level of the serum amylase in 24 hour' s survival group is lower than that of the dead group, and the difference between the two group is nearly significant ( P ＜ 0. 1); ④The pH value in the group with serum amylase ＞ 400 U/L is 7.014 ± 0.228, which is lower than those with serum amylase ＜400 U/L(pH = 7.137 ± 0.167), the difference is very significant (P ＜ 0.005). Conclusion The rise of the serum amylase during CPR indicates unfavorable prognosis.