Polena Sotir, Shen Kuan H, Mamakos Eirene, Chuang Peter J, Sharma Mohan, Griciene Pasaka, Ponomarev Aleksandr A, Gintautas Jonas, Maniar Rajen
Flushing Hospital Medical Center, NY, USA.
Proc West Pharmacol Soc. 2005;48:136-8.
Cardiovascular disease is the leading cause of death in the United States. Acute myocardial infarction (MI) is defined as necrosis of myocardial cells. Several studies have shown that cardiac markers are elevated after successful cardiopulmonary resuscitation (CPR) due to physical as well as electrical trauma. Correlation has never been established between an elevation in cardiac markers and patient age, the amount of trauma induced during resuscitation, or the duration of chest compression. Previous studies have determined that cardiac troponin (cTnl) is the most sensitive marker in cardiac injury. In this study, we hypothesized that the duration of CPR and the patient's age had a direct correlation with cardiac injury demonstrated as an elevation of cTnl. We analyzed retrospectively 81 patients that underwent successful CPR in an in-hospital setting. 13 patients were excluded from the analysis due to positive cTnl prior to cardiac arrest. Duration of CPR, as well as cTnl levels before and after cardiac arrest were recorded and analyzed in the remaining 68 patients. Patients with a negative cTnl after successful CPR (n=30) were stratified into Group A. The remaining patients (Group B) had a positive cTnl ranging from 2.2-31 ng/ml. The mean age and the mean duration of CPR in minutes were calculated and compared using t-Test analysis. There was no statistical difference in age between Group A and Group B. Patients in Group A had a mean CPR duration of 12.2 minutes, while patients in Group B had a mean CPR duration of 19.8 minutes (p < 0.02). We found that the duration of cardiopulmonary resuscitation was positively associated with the elevation of cardiac markers.
心血管疾病是美国的主要死因。急性心肌梗死（MI）被定义为心肌细胞坏死。多项研究表明，由于身体和电击创伤，成功的心肺复苏（CPR）后心脏标志物会升高。心脏标志物升高与患者年龄、复苏期间引起的创伤量或胸外按压持续时间之间从未建立过相关性。先前的研究已确定心肌肌钙蛋白（cTnl）是心脏损伤中最敏感的标志物。在本研究中，我们假设心肺复苏的持续时间和患者年龄与心脏损伤直接相关，表现为cTnl升高。我们回顾性分析了81例在医院环境中接受成功心肺复苏的患者。由于心脏骤停前cTnl呈阳性，13例患者被排除在分析之外。记录并分析了其余68例患者的心肺复苏持续时间以及心脏骤停前后的cTnl水平。成功心肺复苏后cTnl为阴性的患者（n = 30）被分层为A组。其余患者（B组）的cTnl呈阳性，范围为2.2 - 31 ng/ml。使用t检验分析计算并比较了平均年龄和以分钟为单位的平均心肺复苏持续时间。A组和B组之间的年龄无统计学差异。A组患者的平均心肺复苏持续时间为12.2分钟，而B组患者的平均心肺复苏持续时间为19.8分钟（p < 0.02）。我们发现心肺复苏的持续时间与心脏标志物的升高呈正相关。
