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目的探讨心搏骤停后综合征患者血清胆碱酯酶的变化及临床意义。方法选取心搏骤停后综合征患者41例,其中死亡组25例,存活组16例,选取健康体检者20例为对照组,测定三组患者入院时血清胆碱酯酶水平情况和急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分。结果与对照组相比,死亡组血清胆碱酯酶明显降低(P<0.05),而生存组则无明显差异;两组患者APACHEⅡ评分明显升高,差异有统计学意义(P<0.05)。死亡组胆碱酯酶水平明显低于生存组,而APACHEⅡ评分明显高于生存组,差异有统计学意义(P<0.05)。生存组胆碱酯酶异常率为37.5%,死亡组胆碱酯酶异常率为72%(P<0.05)。心搏骤停后综合征患者血清胆碱酯酶水平与APACHEⅡ评分呈负相关(r=-0.315,P=0.01)。结论心搏骤停后综合征死亡患者胆碱酯酶明显降低,动态监测血清胆碱酯酶水平有助于评估心搏骤停后综合征患者的病情危重程度及预后。
Objective To investigate the changes of serum cholinesterase in patients with post-cardiac arrest syndrome and its clinical significance. Methods 41 patients with cardiac arrest syndrome were selected, including 25 deaths and 16 survivors. 20 healthy subjects were selected as the control group. Serum cholinesterase levels and acute physiology And chronic health status Ⅱ (APACHE Ⅱ) score. Results Compared with the control group, serum cholinesterase in the death group was significantly lower (P <0.05), while there was no significant difference in the survival group. The APACHE Ⅱ score was significantly higher in both groups (P <0.05). The level of cholinesterase in the death group was significantly lower than that in the survival group, while the APACHEⅡ score was significantly higher than that in the survival group (P <0.05). The abnormal rate of cholinesterase in survival group was 37.5%, and the abnormal rate of cholinesterase in death group was 72% (P <0.05). Serum cholinesterase levels in patients with post-cardiac arrest syndrome were negatively correlated with APACHE II score (r = -0.315, P = 0.01). Conclusions Cholinesterase in patients with post-cardiac arrest syndrome is significantly lower than that in patients with post-cardiac arrest syndrome. Dynamic monitoring of serum cholinesterase levels may be helpful in assessing the severity and prognosis of patients with post-cardiac arrest syndrome.