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血清BNP与cTnI联合检测与CPR后患者近期临床预后的关系 任长安 于海侠 曹志民 檀立端 刘巧丽 程瑞年* （河北省承德市中心医院急诊科， 河北 承德 067000 ） 摘要 目的 检测血清B型钠尿肽（BNP）与肌钙蛋白I（cTnI）在心脏骤停心肺复苏成功（CPR）患者不同时间的水平变化，探讨CPR后不同时间血清BNP与cTnI水平的变化与近期预后的关系。 方法 分别检测60例CPR患者CPR后即刻、3h、12-24h的血清BNP与cTnI水平，根据血清BNP升高时间分为3组，A组：CPR后即刻、3h、12-24h血清BNP水平一直小于200pg/ml， B组：CPR后3h 和12-24h BNP水平持续升高，且一直大于200pg/ml；C组： CPR后3h 和12-24h BNP水平升高，但12-24h较3h时降低。同时检测三组患者上述3个时间点血清cTnI水平。随访三组患者6个月后的死亡情况。 结果 　随访6个月，BNP和cTnI高表达组患者死亡率均高于低表达组。 结论 CPR过程中，BNP可在心脏早期激活，并且呈动态变化，这对机体是一种保护性反应。但是，如果CPR患者血清BNP大量持续表达，同时由于心肌损伤，血清cTnI明显升高，提示CPR患者出现心功能不全，预后不良。临床上为了改善CPR患者近期预后，治疗上应积极减少心肌损伤，改善心功能不全，提高心排出量，改善重要脏器的血液灌注。 关键词 Change of serum BNP and cTnI in different time after cardiopulmonary resuscitation and the recent clinical prognosise REN Chang-an,YU Hai-xia,CAO Zhi-min,TAN Li-duan,LIU Qiao-li,CHENG Rui-nian* （The emergency department of Chengde city center hospital , Hebei province , Chengde 067000,China Corresponding auther:REN Chang-an, Email:renchangancd@163.com） Abstract Objective To explore the relationship between the level of B-type natriuretic peptide(BNP) and Trononin I in peripheral blood and the Recent clinical prognosis of cardiopulmonary resuscitation(CPR) . Methods A total of 60 victims with sudden cardiac arrest who received CPR were divided into three groups．The victims who the BNP levels has been less than 200pg/ml into Group A．those who the BNP levels at the time of 12-24h after CPR are higher than the time of 0h and 3h after CPR into Group B，and those who the BNP levels at the time of 12-24h after CPR are lower than the time of 0h and 3h after CPR into Group C．detecte serum of three groups of patients in different time At the same time.Follow-up 60 cases with ACS 6 months of mortality incidence. Results 6 months of mortality incidence of Group of patients with high BNP and cTnI express are obviously higher than that of group in low expression. Conclusions The expression of BNP activation at the initial and developing stage may indicate heart f