【摘要】 目的探讨脑电双频指数(BIS)、神经元特异性烯醇化酶(NSE)和S100B对心肺复苏患者预后的评估价值。方法选择2010年7月—2012年6月在我院ICU心肺复苏成功的患者50例,根据预后将患者分为生存组(22例)和死亡组(28例),在入ICU当日予以连续的BIS监测,记录患者急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、格拉斯哥昏迷量表(GCS)评分,并于监测当日取静脉血检测NSE和S100B的水平;分析BIS与GCS评分及NSE、S100B水平的相关性。结果死亡组患者的APACHEⅡ评分高于生存组,入住ICU时间低于生存组,差异均有统计学意义(P<0.05)。死亡组患者的BIS、GCS评分均低于生存组,NSE和S100B水平均高于生存组,差异有统计学意义(P<0.05)。BIS与GCS评分呈正相关(r=0.478,P<0.05),与NSE和S100B水平呈负相关(r=-0.376,P<0.01;r=-0.280,P<0.05)。结论 BIS、NSE和S100B水平能反映心肺复苏成功患者脑损伤的严重程度,对其预后有很好的评估价值。更多还原

【Abstract】 Objective To evaluate the prognostic role of the bispectral index( BIS) monitoring,neuron specific enolase( NSE) and S100B protein( S100B) in patients after cardiopulmonary resuscitation. Methods Fifty adult patients admitted to the intensive care unit( ICU) from July 2010 to June 2012 were divided into survived group( n = 22) and non- survived group( n = 28). During their stay in the ICU,BIS of all the patients were continuously monitored. The neurological status of the patients was measured with Glasgow coma scale( GCS). Acute physiology and chronic health evaluation Ⅱ( APACHE Ⅱ)were also evaluated. The levels of serum NSE and S100B were determined. The studied variables were compared between the two groups. The correlations between BIS and GCS scores,NSE,and S100B were analyzed. Results The APACHE Ⅱ scores,the levels of serum NSE and S100B were significantly higher in the non- survived group than those in survival group( P <0. 05),while the BIS,GCS scores,and the ICU stay were significantly lower in non- survived group than those in survived group( P < 0. 05). Bivariate analyses showed that BIS was positively correlated with GCS( r = 0. 478,P < 0. 05),and negatively correlated with NSE and S100B( r =- 0. 376,P < 0. 01; r =- 0. 280,P < 0. 05). Conclusion The BIS value and the levels of NSE and S100B can reflect the severity of brain damage in patients after cardiopulmonary resuscitation,which could evaluate the prognosis of the patients.更多还原