Relationship between serum SCUBE-1 and LDH levels with cardiac function and prognosis in cardiac arrest patients undergoing cardiopulmonary resuscitation
-
摘要: 目的 心脏骤停心肺复苏(CPR)患者血清信号肽-CUB-表皮生长因子结构域包含蛋白1(SCUBE-1)、乳酸脱氢酶(LDH)水平与心功能及预后的关系。方法 选取2021年2月—2023年2月本院收治的105例心脏骤停CPR患者为研究对象，根据CPR成功后血清SCUBE-1水平变化将其分为3组：CPR后48 h内血清SCUBE-1水平持续<9 ng/mL者为A组(32例)；CPR 48 h后血清SCUBE-1水平仍持续>9 ng/mL者为B组(35例)；CPR后血清SCUBE-1水平>9 ng/mL，但24~48 h内有所降低者为C组(38例)。采用ELISA法测定血清SCUBE-1、LDH水平，并检测各时间点的心功能指标；采用Pearson检验分析患者血清SCUBE-1、LDH水平与心功能指标的相关性。随访6个月观察CPR患者的预后。结果 与B组患者相比较，A组和C组患者血清SCUBE-1、LDH水平呈低表达，C组患者血清SCUBE-1、LDH水平低于B组(均P<0.05)。血清SCUBE-1、LDH水平与左心室舒张末期内径(LVEDD)均呈正相关性(r=0.563、0.476，均P<0.05)，与左心室射血分数(LVEF)均呈负相关性(r=-0.528、-0.513，均P<0.05)。A组6个月生存率高于B组(93.75% vs. 54.29%，χ2=14.148，P<0.001)，B组6个月生存率低于C组(54.29% vs. 84.21%，χ2=8.747，P=0.003)；A组生存率与C组比较差异无统计学意义。血清SCUBE-1、LDH低水平组患者生存率均高于SCUBE-1、LDH高水平组(均P<0.05)。结论 心脏骤停CPR患者血清SCUBE-1、LDH水平与患者心功能和预后密切相关。Abstract: Objective To investigate the relationship between serum signal peptide-CUB epidermal growth factor domain-containing protein 1 (SCUBE-1) and lactate dehydrogenase (LDH) levels with cardiac function and prognosis in cardiac arrest patients undergoing cardiopulmonary resuscitation (CPR).Methods A total of 105 cardiac arrest patients undergoing CPR treated in our hospital from February 2021 to February 2023 were collected. Patients were divided into three groups based on changes in serum SCUBE-1 after successful CPR: Group A (n=32) with serum SCUBE-1 levels<9 ng/mL within 48 hours post-CPR; Group B (n=35) with serum SCUBE-1 levels > 9 ng/mL after 48 hours post-CPR; Group C (n=38) with serum SCUBE-1 levels > 9 ng/mL post-CRP but decreased between 24-48 hours. Serum SCUBE-1 and LDH levels were measured by ELISA. Cardiac function parameters were detected at various time points. Pearson correlation analysis was applied to assess relationships between serum SCUBE-1 and LDH levels and cardiac function parameters. Prognosis of CPR patients was observed during a 6 months follow-up.Results Compared with Group B, patients in Groups A and C exhibited lower serum SCUBE-1 and LDH levels, with Group C showing even lower levels than Group B (all P<0.05). Serum SCUBE-1 and LDH levels were positively correlated with left ventricular end-diastolic dimension (LVEDD) (r = 0.563 and 0.476, respectively; both P<0.05), and negatively correlated with left ventricular ejection fraction (LVEF) (r =-0.528 and -0.513, respectively; both P<0.05). The 6-month survival rate in Group A was significantly higher than that in Group B (93.75% vs. 54.29%, χ2=14.148, P<0.001), while Group B had a lower survival rate than Group C (54.29% vs. 84.21%, χ2=8.747, P=0.003). There was no statistically significant difference in survival rates was observed between Groups A and C. Patients in the low-level SCUBE-1 and LDH groups demonstrated higher survival rates compared to those in the high-level groups (all P<0.05).Conclusion Serum SCUBE-1 and LDH levels are closely related to cardiac function and prognosis in cardiac arrest patients undergoing CPR.
-
-
表 1 患者一般资料比较
Table 1. General data
X±S, 例(%) 项目 A组(32例) B组(35例) C组(38例) χ2/F P 年龄/岁 54.16±6.02 53.85±6.08 54.29±6.03 0.050 0.951 性别 0.021 0.990 男 17(53.13) 19(54.29) 20(52.63) 女 15(46.88) 16(45.71) 18(47.37) CPR时间/min 6.38±1.63 6.46±1.67 7.02±1.75 1.542 0.219 自主循环恢复时间/min 8.74±2.18 8.25±1.16 8.37±1.51 0.796 0.454 电除颤 17(53.13) 19(54.29) 21(55.26) 0.032 0.984 心脏骤停原因 0.877 1.000 严重创伤 10(31.25) 11(31.43) 12(31.58) 脑血管疾病 9(28.13) 8(22.86) 10(26.32) 肺源性疾病 6(18.75) 6(17.14) 7(18.42) 脓毒血症 3(9.38) 4(11.43) 4(10.53) 药物中毒 2(6.25) 3(8.57) 2(5.26) 电击伤 1(3.13) 1(2.86) 1(2.63) 其他 1(3.13) 2(5.71) 2(5.26) 
下载: 导出CSV
表 2 A、B、C组患者CPR后血清SCUBE-1表达水平比较
Table 2. Serum SCUBE-1 levels
ng/mL, X±S 组别 即刻 12 h 24~48 h A组(32例) 6.29±1.26 7.53±1.421) 8.13±0.821)2) B组(35例) 7.03±1.353) 14.87±2.781)3) 26.52±5.281)2)3) C组(38例) 7.12±1.333) 13.21±2.241)3) 11.15±2.631)2)3)4) F 4.020 98.143 279.244 P 0.021 < 0.001 < 0.001 与同组即刻比较，1)P<0.05；与同组12 h比较，2)P<0.05；与A组同时间点比较，3)P<0.05；与B组同时间点比较，4)P<0.05。
下载: 导出CSV
表 3 A、B、C组患者CPR后血清LDH水平比较
Table 3. Serum LDH levels
U/L, X±S 组别 即刻 12 h 24~48 h A组(32例) 217.45±36.72 329.66±45.181) 402.39±51.631)2) B组(35例) 238.34±39.453) 516.35±65.271)3) 687.72±85.461)2)3) C组(38例) 243.55±47.293) 415.18±58.921)3) 496.83±68.371)2)3)4) F 3.704 88.813 145.059 P 0.028 < 0.001 < 0.001 与同组即刻比较，1)P<0.05；与同组12 h比较，2)P<0.05；与A组同时间点比较，3)P<0.05；与B组同时间点比较，4)P<0.05。
下载: 导出CSV
表 4 A、B、C组患者CPR后LVEDD和LVEF水平比较
Table 4. LVEDD and LVEF levels
X±S 组别 即刻 12 h 24~48 h LVEDD/mm LVEF/% LVEDD/mm LVEF/% LVEDD/mm LVEF/% A组(32例) 42.32±5.93 55.25±5.83 48.45±6.051) 51.78±7.471) 53.65±6.341)2) 47.26±5.081)2) B组(35例) 46.21±5.263) 50.42±5.763) 61.71±7.131)3) 36.54±6.871)3) 63.52±7.281)2)3) 32.56±6.671)2)3) C组(38例) 51.43±6.183)4) 45.29±5.053)4) 55.48±6.161)3)4) 39.95±7.301)3)4) 58.47±6.191)2)3)4) 36.85±4.631)2)3)4) F 21.734 28.248 35.132 40.804 18.629 62.286 P < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 与同组即刻比较，1)P<0.05；与同组12 h比较，2)P<0.05；与A组同时间点比较，3)P<0.05；与B组同时间点比较，4)P<0.05。
下载: 导出CSV
表 5 血清SCUBE-1、LDH水平与LVEDD、LVEF的相关性
Table 5. Correlation between serum SCUBE-1, LDH levels and LVEDD, LVEF
项目 SCUBE-1 LDH r P r P LVEDD 0.563 < 0.001 0.476 < 0.001 LVEF -0.528 < 0.001 -0.513 < 0.001
下载: 导出CSV
表 6 不同血清SCUBE-1和LDH水平组患者6个月生存率比较
Table 6. Six-month survival rates among patients with different serum SCUBE-1 and LDH level groups
例(%) 组别 生存 χ2 P 血清SCUBE-1水平 13.598 < 0.001 高表达组(54例) 35(64.81) 低表达组(51例) 48(94.12) 血清LDH水平 7.994 0.005 高表达组(53例) 36(67.92) 低表达组(52例) 47(90.38)
下载: 导出CSV
-
[1] Rodríguez-Reyes H, Muñoz-Gutiérrez M, Salas-Pacheco JL. Current behavior of sudden cardiac arrest and sudden death[J]. Arch Cardiol Mex, 2020, 90(2): 200-206.
[2] 沈玉祥. 中国变异型心绞痛临床研究面临机遇与挑战[J]. 临床心血管病杂志, 2024, 40(2): 84-88. doi: 10.13201/j.issn.1001-1439.2024.02.002
[3] 何川鄂, 饶毅峰, 宋志霞, 等. 血清SCUBE-1及EndoCan水平与血液透析患者动静脉内瘘血栓形成的关系[J]. 西部医学, 2023, 35(2): 227-231. doi: 10.3969/j.issn.1672-3511.2023.02.014
[4] Icel E, Icel A, Mertoglu C, et al. Serum SCUBE-1 levels in patients with diabetic retinopathy[J]. Int Ophthalmol, 2020, 40(4): 859-865. doi: 10.1007/s10792-019-01249-8
[5] Ayvaz Çelik HH, Kuyumcu MS, Şirin FB, et al. Could SCUBE-1 be a marker for subclinical atherosclerosis other than carotid artery intima-media thickness in patients with psoriasis?[J]An Bras Dermatol, 2023, 98(5): 595-601. doi: 10.1016/j.abd.2022.08.012
[6] Gordon JS, Wood CT, Luc JGY, et al. Clinical implications of LDH isoenzymes in hemolysis and continuous-flow left ventricular assist device-induced thrombosis[J]. Artif Organs, 2020, 44(3): 231-238. doi: 10.1111/aor.13565
[7] Claps G, Faouzi S, Quidville V, et al. The multiple roles of LDH in cancer[J]. Nat Rev Clin Oncol, 2022, 19(12): 749-762. doi: 10.1038/s41571-022-00686-2
[8] 李春盛, 季宪飞. 2010美国心脏学会心肺复苏与心血管急救指南解读[J]. 心脑血管病防治, 2011, 11(4): 253-256. doi: 10.3969/j.issn.1009-816X.2011.04.001
[9] Yilmaz C, Gülen B, Sönmez E, et al. Serum SCUBE-1 Levels and Return of Spontaneous Circulation Following Cardiopulmonary Resuscitation in Adult Patients[J]. Avicenna J Med, 2022, 12(3): 148-153. doi: 10.1055/s-0042-1755389
[10] Navalpotro-Pascual JM, Fernández Pérez C, Peinado Vallejo FA, et al. Caseload and cardiopulmonary arrest management by an out-of-hospital emergency service during the COVID-19 pandemic[J]. Emergencias, 2021, 33(2): 100-106.
[11] Miraglia D, Almanzar C, Rivera E, et al. Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: a scoping review[J]. J Am Coll Emerg Physicians Open, 2021, 2(1): e12380. doi: 10.1002/emp2.12380
[12] Zanders R, Druwé P, Van Den Noortgate N, et al. The outcome of in-and out-hospital cardiopulmonary arrest in the older population: a scoping review[J]. Eur Geriatr Med, 2021, 12(4): 695-723. doi: 10.1007/s41999-021-00454-y
[13] Erdoǧan M, Findikli HA, Okuducu Teran. A novel biomarker for predicting sepsis mortality: SCUBE-1[J]. Medicine(Baltimore), 2021, 100(6): e24671.
[14] Lin YC, Sahoo BK, Gau SS, et al. The biology of SCUBE[J]. J Biomed Sci, 2023, 30(1): 33. doi: 10.1186/s12929-023-00925-3
[15] Ilden O, Selcuk OT, Ellidag HY, et al. An evaluation of the change in serum SCUBE-1 levels with CPAP treatment in patients with severe obstructive sleep apnea[J]. Cranio, 2022, 13(1): 1-7.
[16] Serrano-Lorenzo P, Coya ON, López-Jimenez A, et al. Plasma LDH: A specific biomarker for lung affectation in COVID-19?[J]. Pract Lab Med, 2021, 25(1): e00226.
[17] Jin H, Bi R, Hu J, et al. Elevated Serum Lactate Dehydrogenase Predicts Unfavorable Outcomes After rt-PA Thrombolysis in Ischemic Stroke Patients[J]. Front Neurol, 2022, 13(1): 816216.
[18] Kim J, Kim YW, Kim TY. Diagnostic Value of Serum Lactate Dehydrogenase Level Measured in the Emergency Department in Predicting Clinical Outcome in Out-of-Hospital Cardiac Arrest: A Multicenter, Observational Study[J]. J Clin Med, 2023, 12(8): 3006. doi: 10.3390/jcm12083006
-
计量
- 文章访问数: 24
- 施引文献: 0