高级氧化蛋白产物在心肺脑复苏后的检测及其意义

目的：探讨心搏骤停患者经心肺脑复苏（CPCR）后体内高级氧化蛋白产物（AOPP）的变化及其临床意义。方法：用分光光度计法检测心搏骤停患者经CPCR后外周静脉血清AOPP浓度，同时对心肺脑复苏后患者进行急性生理学与慢性健康状况（APACHE）Ⅲ评分，并记录30天内患者的生存或死亡情况，分析血清AOPP浓度与器官功能障碍程度和病情转归的关系。结果：血清AOPP水平和APACHEⅢ评分在PR．MODS组[（156．60±28．04）mol／L，（96．39±24．78）分]和死亡组[（189．92±34．86）mol／L，（110．46±32．47）分]分别明显高于非PR—MODS组[（88．76±10．13）mol／L，（69．34±16．33）分]和存活组[（128．49±36．65）mol／L，（78．65±20．92）分]（P〈0．05）；血清AOPP水平和APACttEⅢ评分呈高度正相关（r=0．528，P〈0．01）。结论：心搏骤停和CPCR过程激活机体氧化应激状态，蛋白质氧化应激产物增加．AOPP水平对PR—MODS的发生及判断病情轻重和预后评估具有重要参考价值。

The Role and Clinical Significance of Advanced Oxidized Protein Products in Patients after Cardiopulmonary-cerebral Resuscitation

Objective： To investigate the role and clinical significance of advanced oxidized protein products （AOPP） in patients after cardiopulmorary-cerebral resuscitation. Methods： Serum AOPP levels were determined in 46 patients after cardiopulmonary-cerebral resuscitation. APACHE Ⅲ scoring system was applied to assess patients＇ severity. The differences of serum AOPP among post-resuscitation multiple organ dysfunction syndrome （PR-MODS） group, non-PR-MODS group and normal control group, together with differences between survival and dead subjects within 30 days, were compared. The correlations between AOPP levels and APACHE Ⅲ score were also observed. Results： The AOPP levels and APACHE Ⅲ score-in both PR-MODS group [（156.60±28.04）mol/L, （96.39±24.78）] and death group[ （189.92±34.86） mol/L, （110.46±32.47）] were higher than those in non-PR-MODS group[ （88.76± 10.13 ） mol/L, （69.34 ± 16.33 ） ] and survival group [ （ 128.49 ±36.65 ） mol/L, （78.65 ±20.92） 分 ], respectively （P〈 0.05）. Positive correlations were noted between AOPP levels and APACHE Ⅲ score （r =0.528, P〈0.01）. Conclusion： Cardiac arrest and the CPCR procedure can activate oxidative stress and induce the formation of AOPP. AOPP may play an important role in the pathophysiology of PR-MODS.The serum AOPP level may be taken as a diagnostic and prognostic indicator for PR-MODS.