50例非心源性猝死患者心肺复苏后24小时内左室功能变化的临床研究

目的：研究心肺复苏后多器官功能障碍综合征（PR-MODS）患者在24h内左心室功能变化规律。方法：对急诊50例既往无心功能障碍的PRMODS患者，监测心肺复苏后12、24h左心室舒张末期容积（LVEDV）、收缩末期容积（LVESV）、射血分数（LVEF）和每搏输出量（SV）。将存活〉12h组与存活〈12h组比较。结果：存活〉12h组（36例）其LVEDV和LVESV高于正常值（106．22±16．06）ml vs （70．0±20．0）ml，t=16．96，P〈0．01；（46．94±11．72）ml vs （24．0±10．0）ml，t=11．74，P〈0．01）]；且其12h内LVEDV和LVESV低于存活〈12h组（14例）（112．58±16．06）ml vs（129．35±21．15）ml，t=3．03，P〈0．01；（51．56±14．12）ml vs （64．14±14．32）ml，t=2．82，P％0．01）]。存活〉12h组其LVEF和SV低于正常值（48．78％±5．76％）vs 〉50％；（62．17±5．56）ml vs（71．3±9．97）ml ，t=7．74，P〈0．01）]；且12h内LVEF和SV高于存活〈12h组（45．06％±6．62％）vs （39．43％±8．14％），t=2．53，P〈0．01；（56．31±7．10）ml vs（54．57±6．80）ml，t=0．78，P〈0．01）]。结论：PR-MODS患者左心功能均较正常低下，且存活时间与心脏损伤程度有关。

Clinical Research on Changes of Left Ventricular Function Within 24 Hours After CPR in 50 Cases With Non-cardiogenic Arrest

Objective：To study the changes of left ventricular function within 24 hours after CPR in patients with multiple organ dysfunction syndrome （PR MODS）. Methods： Left ventricular end diastolic volume （LVEDV）, left ventricular end systolic volume （LVESV）,left ventricular ejection fraction （LVEF） and systolic volume （SV） were detected in 50 cases with PR-MODS without previous cardiac dysfunction. The patients survived more than 12 hours and less than 12 hours were compared. Results： LVEDV （106. 22 ± 16. 06）ml vs （70. 0 ± 20. 0）ml,t = 16.96, P〈 0. 01） ] and LVESV （46. 94 ± 11.72） ml vs （24. 0 ± 10. 0） ml, t = 11.74, P〈0. 01 ） ] were over the normal value in 36 cases survived more than 12 hours, and within 12 hours LVEDV （112. 58 ± 16. 06）ml vs （129. 35 ± 21.15）ml, t = 3.03, P〈0. 01）] and LVESV （51.56 ±14. 12）ml vs （64. 14 ± 14. 32）ml,t = 2. 82, P〈0. 01）] were lower than those of patients （14 cases） survived less than 12 hours. LVEF （48.78%± 5. 76%） vs 〉50%] and SV （62. 17 ± 5.56）ml vs （71.3 ±9. 97）ml, t = 7. 74, P〈0. 01）1]were lower than normal value in patients survived more than 12 hours. LVEF （45.06% ±6. 62%） vs （39. 43% ± 8. 14%）, t = 2. 53,P〈0. 01）] and SV （56. 31 ±7. 10）ml vs （54. 57±6. 80）ml,t = 0. 78,P〈0. 01）1 were higher than those of patients survived less than 12 hours. Conclusion： The left ventricular function is impaired in patients with PR-MODS and the survival time is correlated to the degree of their heart injury.