【摘要】 目的探讨心肺复苏后患者血管紧张素Ⅱ(AⅡ)与醛固酮(ALD)分离现象及其临床意义。方法以放射免疫法测定60例心肺复苏后患者(A组)和35例健康成年人(B组)血中皮质醇(COR)、AⅡ和ALD的含量。结果(1)A组的COR为(471.54±29.78)nmol/L、AⅡ(97.69±13.35)ng/L、ALD(261.03±34.13)pmol/L均分别显著高于B组的(411.52±21.94)nmol/L、(63.70±9.71)ng/L、(242.91±21.03)pmol/L(P<0.05)。(2)在60例心肺复苏后患者中,低ALD的发生率为35%(21/60),高ALD率为51.67%(31/60)。(3)低ALD组的平均动脉血压(42.26±11.93)mm Hg,非低ALD组(53.59±9.88)mm Hg(P<0.05);低ALD组器官衰竭个数(3.81±0.73)、病死率90.48%、快速型室上性心律失常发生率71.43%(16/21)、快速型室性心律失常61.91%(13/21),均分别高于非低ALD患者组[(2.55±0.69)、51.29%、46.16%和30.77%](P<0.05)。结论心肺复苏后患者中存在AⅡ-ALD分离现象并非罕见,而且病情更严重,预后更差,病死率高。更多还原

【Abstract】 Objective To research dissociation of angiotensinⅡ(AⅡ) and aldosterone(ALD) in patients undergoing cardiopulmonary resuscitation(CPR).Methods Plasma levels of cortisol(COR),AⅡ and ALD were measured by radioimmunoassay in 60 patients with CPR(group A) and 35 normal persons(group B).Results (1)The COR,AⅡ and ALD concentrations of group A were significantly higher than those of group B(P<0.01 or P<0.05).(1)Among 60 cases of CPR,the lower ALD rate was 35%(21/60),the higher ALD rate was 51.67%(31/60).(3)The mean blood pressures in lower ALD group(42.26±11.93)mmHg were significantly lower than those in non-lower ALD group(53.59±9.88)mmHg(P<0.05).The members of organ dysfunction(3.81±0.73) and death rate(90.48%) in lower ALD group were obviously higher than those(2.45±0.69,45.45%) in non-lower ALD group(allP<0.05).(4)Incidences of supraventricular and ventricular tachyarrhythmia in lower ALD group were significantly higher than those in non-lower ALD group(P<0.05).Conclusion That dissociation of AⅡ and ALD in patients with CPR is not rare.There are higher severity of disease,severe prognosis and higher death rate in dissociation of AⅡ and ALD in patients with CPR.更多还原