Tat Raluca M, Golea Adela, Rahaian Rodica, Vesa Ştefan C, Ionescu Daniela
Department of Anesthesia and Intensive Care I, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Surgical Department of "Iuliu Haţieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
J Clin Med. 2019 Dec 25;9(1):57. doi: 10.3390/jcm9010057.
. The systemic response to ischemia-reperfusion that occurs after a cardiac arrest (CA) followed by the return of spontaneous circulation leads to endothelial toxicity and cytokine production, both responsible for the subsequent occurrence of severe cardiocirculatory dysfunction and early death. Resistin is emerging as a biomarker of proinflammatory status and myocardial ischemic injury and as a mediator of endothelial dysfunction. The study aimed to analyze the possible associations between several clinical and biological variables and the serum levels of resistin in CA survivors. Forty patients with out-of-hospital resuscitated CA, were enrolled in the study. Demographic, clinical and laboratory data (including serum resistin measurements at admission and at 6, 12, 24, 48 and 72 h) were recorded. For resistin, we calculated the area under the curve (AUC) using the trapezoidal method with measurements from 0 to 12 h, 0 to 24 h, 0 to 48 h and 0 to 72 h. Fifteen (37.5%) patients died in the first 72 h after CA. Cardiovascular comorbidities were present in 65% of patients. The majority of patients had post-CA shock (29 (72.5%)). Resistin serum levels rose in the first 12-24 h and decreased in the next 48-72 h. In univariate analysis, advanced age, longer duration of resuscitation, high sequential organ failure assessment score, high lactate levels, presence of cardiovascular comorbidities and the post-CA shock were associated with higher resistin levels. In multivariate analysis, post-CA shock or cardiovascular comorbidities were independently associated with higher AUCs for resistin for 0-12 h and 0-24 h. The only identified variable to independently predict higher AUCs for resistin for 0-48 h and 0-72 h was the presence of post-CA shock. Our data demonstrate strong independent correlation between high serum resistin levels, cardiac comorbidities and post-CA shock. The impact of the post-CA shock on serum concentration of resistin was greater than that of cardiac comorbidities.
心脏骤停（CA）后出现自主循环恢复，其引发的全身缺血再灌注反应会导致内皮毒性和细胞因子产生，二者均是随后发生严重心循环功能障碍和早期死亡的原因。抵抗素正逐渐成为促炎状态和心肌缺血损伤的生物标志物以及内皮功能障碍的介质。本研究旨在分析CA幸存者中若干临床和生物学变量与抵抗素血清水平之间的可能关联。40例院外复苏成功的CA患者纳入本研究。记录人口统计学、临床和实验室数据（包括入院时以及6、12、24、48和72小时时的血清抵抗素测量值）。对于抵抗素，我们使用梯形法计算曲线下面积（AUC），测量时间为0至12小时、0至24小时、0至48小时和0至72小时。15例（37.5%）患者在CA后72小时内死亡。65%的患者存在心血管合并症。大多数患者发生CA后休克（29例（72.5%））。抵抗素血清水平在最初12 - 24小时升高，在随后48 - 72小时降低。单因素分析中，高龄、复苏持续时间较长、序贯器官衰竭评估评分高、乳酸水平高、存在心血管合并症以及CA后休克与较高的抵抗素水平相关。多因素分析中，CA后休克或心血管合并症与0至12小时和0至24小时抵抗素的较高AUC独立相关。唯一被确定可独立预测0至48小时和0至72小时抵抗素较高AUC的变量是CA后休克的存在。我们的数据表明血清抵抗素水平高、心脏合并症与CA后休克之间存在强烈的独立相关性。CA后休克对抵抗素血清浓度的影响大于心脏合并症。
