心肺复苏不同预后患者血清细胞因子ET-1的变化与预后的关系

Changes of Cytokines, ET-1 in the Peripheral Blood of Patients with Cardiopulmonary Resuscitation and Its Relationship with Prognosis

摘要: 目的：观察心脏骤停患者心肺复苏后外周血中促炎/抗炎细胞因子、内皮素(ET-1)含量变化及其与预后的关系。方法：56例心脏骤停后心肺复苏患者依据复苏效果分为三组，A组：20例心肺复苏30 min无效死亡；B组：20例，复苏成功，自主循环建立 ≥ 2 h，但最终死亡；C组：16例，复苏成功，存活出院。选择20例健康门诊体检者作为对照D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。结果：与D组比较，A、B和C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C组比较，A和B组IL-1β、TNF-α、IL-4、IL-10和ET-1含量明显增高(p < 0.05)；与B组比较，A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)。结论：促炎/抗炎细胞因子(IL-1β，TNF-α，IL-4，IL-10)异常释放与ET-1参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。

Abstract: Objective: To investigate the changes of ET-1 in the peripheral blood of patients with cardiopul-monary resuscitation and its relationship with prognosis. Methods: 56 patients with cardiopul-monary resuscitation after cardiac arrest were divided into group A (20 cases, cardiopulmonary resuscitation lasting for 30 min, then died), group B (20 cases, independent circulation was more than or equal to 2 h, but eventually died), and group C (16 cases, survival). Twenty healthy subjects were used as control (group D). Interleukin (IL)-1β, TNF-α, IL-4 and IL-10 content was determined by ELISA. ET-1 content was determined by radioimmunoassay. Results: Compared with group D, IL-1β, TNF-α, IL-4, IL-10 and ET-1 contents were significantly higher in peripheral blood of group A, B and C (p < 0.05). Compared with group C, IL-1β, TNF-α, IL-4, IL-10 and ET-1 contents were significantly increased in group A and B (p < 0.05). IL-1β, TNF-α, IL-4 and IL-10 content was not significantly different between group A and B, but the content of ET-1 was increased significantly in group B than group A (p < 0.05). Conclusion: The abnormal release of pro/ anti-inflam- matory cytokine (IL-1β, TNF-α, IL-4, IL-10) and ET-1 is involved in the development of ischemia reperfusion injury after cardiopulmonary resuscitation, and is closely related with the prognosis of cardiopulmonary resuscitation.