心肺复苏成功患者早期发生心血管衰竭的影响因素分析

doi:10.3969/j.issn.1006-6233.2025.05.025

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摘要 目的: 分析心肺复苏(CPR)成功患者早期发生心血管衰竭的影响因素。方法: 选择2022年1月至2024年1月在我院接受CPR后恢复自主循环(ROSC)的132例患者,以复苏后72h内的心血管状态变化进行分组,发生心血管衰竭纳入心血管衰竭组,未发生心血管衰竭纳入非心血管衰竭组。比较两组人口学资料、病史、CPR相关资料、血液生化指标,使用多因素Logistic回归分析得出CPR成功患者早期发生心血管衰竭的独立影响因素。结果: 132例复苏成功患者中有91例早期发生心血管衰竭,发生率为68.94%。心血管衰竭组年龄大于非心血管衰竭组,高血压、糖尿病、吸烟比例高于非心血管衰竭组,复苏持续时间长于非心血管衰竭组,除颤前使用肾上腺素比例高于非心血管衰竭组,ROSC后血乳酸、脑钠肽(BNP)、血清肌酐(SCr)水平高于非心血管衰竭组,差异均有统计学意义(P<0.05)。心血管衰竭组内皮素-1(ET-1)、一氧化氮(NO)、血管性假血友病因子(vWF)水平高于非心血管衰竭组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,高血压、复苏持续时间、除颤前使用肾上腺素及ET-1是CPR成功患者早期发生心血管衰竭的独立影响因素(P<0.05)。结论: CPR成功患者早期发生心血管衰竭与高血压、复苏持续时间长、除颤前使用肾上腺素及高ET-1水平密切相关,临床上应加强对高危患者的监测与管理。

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关键词 ：心脏骤停, 心肺复苏, 成功, 心血管衰竭, 独立影响因素

Abstract：Objective: To analyze the influencing factors of early cardiovascular failure in patients with successful cardiopulmonary resuscitation (CPR). Methods: A total of 132 patients who achieved return of spontaneous circulation (ROSC) after CPR in our hospital from January 2022 to January 2024 were selected. Patients were divided into a cardiovascular failure group (occurred within 72 hours after resuscitation) and a non-cardiovascular failure group (not occurred) based on cardiovascular status changes after resuscitation. Demographic data, medical history, CPR-related parameters, and blood biochemical indices were compared between the two groups. Multivariate logistic regression analysis was used to identify independent risk factors for early cardiovascular failure in successfully resuscitated patients. Results: Among 132 successfully resuscitated patients, 91 developed early cardiovascular failure, with an incidence of 68.94%. The cardiovascular failure group had significantly older age, higher proportions of hypertension, diabetes, and smoking, longer CPR duration, higher proportion of epinephrine use before defibrillation, and higher levels of blood lactate, brain natriuretic peptide (BNP), and serum creatinine (SCr) after ROSC compared with the non-cardiovascular failure group (all P<0.05). Levels of endothelin-1 (ET-1), nitric oxide (NO), and von Willebrand factor (vWF) were also significantly higher in the cardiovascular failure group (P<0.05). Logistic regression analysis showed that hypertension, CPR duration, epinephrine use before defibrillation, and ET-1 were independent risk factors for early cardiovascular failure in successfully resuscitated patients (P<0.05). Conclusion: The occurrence of early cardiovascular failure in patients with successful CPR is closely related to hypertension, long duration of resuscitation, use of adrenaline before defibrillation and elevated ET-1 level. Clinical monitoring and management of high-risk patients should be strengthened.

Key words： Cardiac arrest Cardiopulmonary resuscitation Successful Cardiovascular failure Independent influencing factor

基金资助:山西省卫生健康委科研课题,(编号:2020161)

引用本文:

张瑞辰, 程艳, 颜娇, 葛晓, 孙春燕. 心肺复苏成功患者早期发生心血管衰竭的影响因素分析[J]. 河北医学, 2025, 31(5): 843-848.
ZHANG Ruichen, CHENG Yan, YAN Jiao, et al. Influencing Factors for Early Cardiovascular Failure in Patients with Successful Cardiopulmonary Resuscitation. HeBei Med, 2025, 31(5): 843-848.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.05.025 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I5/843

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