摘要
目的分析格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分联合血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)评估急诊心肺复苏术(cardiopulmonary resuscitation,CPR)患者脑功能及预后的价值。方法选取2020年1月至2022年12月宜春市人民医院收治的70例急诊CPR成功患者作为研究对象,复苏后24 h内进行脑电双频指数(bispectral index,BIS)监测,比较不同BIS值患者GCS评分、血清NSE水平,采用Pearson相关性分析BIS值与GCS评分、血清NSE水平的相关性;采用多因素Logistic回归分析CPR患者预后不良的危险因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析GCS评分联合血清NSE水平对急诊CPR患者预后的评估价值。结果不同BIS值患者GCS评分、血清NSE水平比较差异有统计学意义(P<0.05);BIS值>60患者GCS评分、血清NSE水平均高于41~60、0~40患者,且41~60患者高于0~40患者,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,BIS值与GCS评分呈正相关(r>0,P<0.05),与血清NSE水平呈负相关(r<0,P<0.05);多因素Logistic回归分析结果显示,GCS评分、血清NSE水平是CPR患者预后不良的独立危险因素(P<0.05);ROC曲线分析结果显示,GCS评分、血清NSE两者联合检测评估CPR患者预后的曲线下面积、灵敏度、特异度分别为0.881、90.50%、78.60%,其曲线下面积、灵敏度均高于单一检测。结论GCS评分及血清NSE水平可反映急诊CPR患者脑功能及预后,两者联合对急诊CPR患者脑功能及预后具有较高的评估价值。
Objective To analyze the value of Glasgow coma scale(GCS)score combined with serum neuron-specific enolase(NSE)in evaluating brain function and prognosis in patients undergoing emergency cardiopulmonary resuscitation(CPR).Methods 70 patients who underwent successful emergency CPR at Yichun People's Hospital from January 2020 to December 2022 were selected as the study subjects.Bispectral index(BIS)monitoring was performed within 24 h after resuscitation.GCS scores and serum NSE levels of patients were compared among different BIS values,Pearson correlation analysis was used to investigate the correlation between BIS value and GCS score and serum NSE level.Multivariate Logistic regression analysis was used to identify risk factors for poor prognosis in patients undergoing emergency CPR.The receiver operating characteristic(ROC)curve was plotted to evaluate the prognostic value of GCS score combined with serum NSE level in patients undergoing emergency CPR.Results There were significant differences in GCS score and serum NSE level among patients with different BIS values(P<0.05);GCS scores and serum NSE levels of the BIS value>60 patients were higher than those of 41-60 and 0-40 patients,and the 41-60 patients was higher than 0-40 patients,and the differences were statistically significant(P<0.05).Pearson correlation analysis results showed that BIS value was positively correlated with GCS score(r>0,P<0.05),and negatively correlated with serum NSE level(r<0,P<0.05).Multivariate Logistic regression analysis results showed that GCS score and serum NSE level were independent risk factors for poor prognosis in patients undergoing emergency CPR(P<0.05).ROC curve analysis results showed that area under curve,sensitivity and specificity of GCS score combined with serum NSE for evaluating the prognosis in patients undergoing emergency CPR were 0.881,90.50%and 78.60%,respectively,and the area under the curve and sensitivity were higher than those of single detection.Conclusion GCS score and serum NSE level can reflect brain function and prognosis in patients undergoing emergency CPR,Combination of the two has high value in evaluating brain function and prognosis in patients undergoing emergency CPR.
作者
叶勇
曾俊锋
陈英果
YE Yong;ZENG Junfeng;CHEN Yingguo(Emergency Management,Yichun Emergency Rescue Center,Yichun,Jiangxi,336000,China;Department of Emergency,Yichun People's Hospital,Yichun,Jiangxi,336000,China)
出处
《当代医学》
2024年第32期89-93,共5页
Contemporary Medicine
关键词
急诊心肺复苏术
格斯拉昏迷评分
神经元特异性烯醇化酶
脑功能
预后
评估
Emergency cardiopulmonary resuscitation
Glasgow coma scale score
Neuron-specific enolase
Brain function
Prognosis
Evaluation
