心肺复苏后血清S100蛋白早期水平对生存出院的预测价值

目的探讨心肺复苏(CPR)后血清S100蛋白(S100)水平变化对患者生存出院的预测价值。方法选择25例经CPR自主循环恢复(ROSC)后收入ICU的患者,将CPR成功后生存患者分为生存组12例,院内病死患者为死亡组13例。所有患者均在ROSC后2、12、24、48h分别采取静脉血,采用电化学发光免疫法检测S100;同时收集入ICU后24h内临床资料,计算各时间段急性生理学与慢性健康状况Ⅱ、Ⅲ评分(APACHEⅡ、Ⅲ)及存活概率(PS)。结果①死亡组APACHEⅡ、Ⅲ评分明显高于生存组(P<0.01),PS、GCS评分明显低于生存组(P<0.05),开始通气时间、ROSC时间比生存组明显长(P<0.05);②生存组在2、12、48hS100水平明显低于死亡组(P<0.01);③S100的ROC曲线下面积(AUC)为0.903(P=0.001),以S100水平0.165μg/L作为诊断界点(cutoff值),ROSC后2hS100对CPR后生存出院的阳性预测值为100%、阴性预测值73%(P=0.002),12h分别为100%和76.47%(P=0.001);预测院内死亡ROSC后2h灵敏度93.3%、特异度61.5%(P=0.001);12h分别为93.3%和58.3%(P=0.001)。结论心肺复苏后早期血清S100水平对评估患者生存出院的预测具有重要临床意义。

Value of early levels of serum S100 protein to predict survival discharge after successful cardiopulmonary resuscitation

Objective To evaluate the effects of serum protein S-100(S-100)on prediction survival discharge at the early stage after cardiopulmonary resuscitation(CPR). Methods Twenty-five patients undergone successful CPR with restoration of spontaneous circulation (ROSC) were admitted to ICU. According to survival discharge or death after CPR, all the patients were divided into two groups. The values of serum S-100 were detected respectively at 2h, 12h, 24h, 48h after ROSC with lmmunoluminometric method. At the same ...