【摘要】 目的 探讨心肺复苏后外周血中促炎/抗炎细胞因子、内皮素(ET-1)和NO含量变化及其与预后的关系。方法 60例心脏骤停后心肺复苏患者依据复苏效果分为三组,S1组:20例,心肺复苏30 min无效死亡;S2组:20例,复苏成功,自主循环建立≥2 h,但最终死亡;H组:20例,复苏成功,存活出院。选择20例健康门诊体检者作为对照C组。于心肺复苏即刻留取静脉血,用ELISA法检测外周血中白细胞介素(IL)-1β、TNF-α、IL-4和IL-10含量变化;采用放射免疫法检测ET-1含量,硝酸根还原酶法检测NO含量。结果 与C组比较,S1、S2和H组外周血中IL-1β、TNF-α、IL-4、IL-10和ET-1含量明显增高(P<0.05);与H组比较,S1和S2组IL-1β、T’NF-α、IL-4、IL-10和ET-1含量明显增高(P<0.05);与S2组比较,S1组IL-1β、TNF-α、IL-4和IL-10含量无明显不同,ET-1含量明显增高(P<0.05)。与C组比较,S1、S2和H组NO含量明显降低(P<0.05);与H组比较,S1和S2组NO含量明显降低(P<0.05);与S2组比较,S1组NO含量明显降低(P<0.05)。结论 促炎/抗炎细胞因子(IL-1β、TNF-o、IL-4、IL-10)异常释放与ET-1、NO参与心肺复苏后缺血再灌注损伤的发生发展,且与心肺复苏预后密切相关。更多还原

【Abstract】 Objective To explore the changes of ET- 1 and NO content in the peripheral blood after cardiopulmonary resuscitation and its relationship with prognosis.Methods 60 patients of cardiopulmonary resuscitation after cardiac arrest were divided into group SI(20 cases,cardiopulmonary resuscitation lasting for 30 min,then died),group S2(20 cases,independent circulation was greater than or equal to 2 h,but eventually died),and group H(20 cases,survival).Twenty healthy subjects were used as control(group C).Interleukin(IL)-1β,TNF- α,IL- 4 and IL- 10 content was determined by ELISA.ET- 1 content was determined by radioimmunoassay,and NO content was detected by nitrate reductase.Results Compared with group C,IL — 1β,TNF- α,IL- 4,IL- 10 and ET- 1 were significantly higher in peripheral blood of patients of group SI,S2 and H(P <0.05).Compared with group H,IL- 1β,TNF- α,1L-4,IL — 10 and ET — 1 contents were significantly increased in group S1 and S2(P < 0.05).IL- 1β,TNF- α,IL-4 and IL- 10 content was not significantly different between group S2 and SI,but the content of ET- 1 was increased significantly in group S2 than group S1(P<0.05).Compared with group C,NO content was significantly reduced in group S1,S2 and H(P < 0.05).Compared with group H,NO content was significantly reduced in group S1 and S2(P < 0.05).Compared with group S2,NO content was decreased significantly in group S1(P<0.05).Conclusion The abnormal release of pro/anti-inflammatory cytokine(IL-1β,TNF-α,IL-4,IL-10) and ET-1,NO is involved in the development of ischemia reperfusion injury after cardiopulmonary resuscitation,and is closely related with the prognosis of cardiopulmonary resuscitation.更多还原