【摘要】 目的探测评估心肺复苏(CPR)后神经功能预后的NSE临界值,分析NSE含量与GPC评分相关性,探讨两种指标联合监测对评估CPR后神经功能预后评估的价值。方法收集2009年1月~2010年6月本院神经内科和中心ICU收治的心肺复苏后恢复自主循环仍处昏迷状态的患者,共60例。根据预后将患者分为生存组和病死组,对两组患者行GPC评分,并在心肺复苏后48h行血清NSE检测,采用SPSS10.0统计学软件分析组间各指标的差异性,绘制ROC曲线,评估血清NSE的最优截断点(Cutoff值)。结果病死组GPC评分和血NSE含量水平均高于生存组,两组比较差异具有显著性(P<0.05)。根据ROC曲线计算得出,以血清NSE水平来预测患者病死率,其Cutoff值为56.50ng/ml,其诊断灵敏度为80.8%,特异度为65.6%。以Cutoff值为界将患者分为<56.50ng/ml组和≥56.50ng/ml组,两组在GPC评分及实际病死率方面均有显著性差异(P均<0.05)。结论 NSE评估心肺复苏后脑功能预后的Cutoff值为56.50ng/ml,其可与GPC联合应用于病情严重程度的评估以及预测死亡危险度。更多还原

【Abstract】 Objective To evaluate the effect of serum neuron specific enolase(NSE) on the brain function evaluation of the patients after cardiopulmonary resuscitation.Methods Sixty patients after cardiopulmonary resuscitation in author’s hospital from January in 2009 to June in 2010.The values of serum NSE were detected in 48 hours,at the same time,Pittsburgh coma scale(GPC) were calculated according to clinical data.The patients were divided into survival group and death group.And then we analyzed their NSE level and GPC by SPSS 10.0.The cutoff level of serum NSE for anticipating mortality was evaluated according to ROC.Results Compared with the survival group,GPC and the serum NSE values were significantly different in the death group(P<0.05).According to ROC,the cutoff level of serum NSE for anticipating mortality was 56.50 ng/ml,the sensitivity was 80.8%,the specificity was 65.6%.GPC and actual mortality were significantly different between the groups classified by the level of serum NSE(NSE <56.50 ng/ml and NSE 56.50 ng/ml)(P<0.05).Conclusions The cutoff level of serum NSE for anticipating mortality was 56.50ng/ml,The serum NSE combined by GPC can be used to evaluate the disease severity of patients after cardiopulmonary resuscitation and anticipate the death.更多还原