The Clinic Analysis Of Nephritic Injure In Cardiopulmonary Resuscitation After The Cardiac Arrest

Objective:To investigate the clinical meaning of changes about blood blood serum creatinine,urine protein,white blood cell,tumor necrosis factor alpha,interleukin-1 urea nitrogen,urine red cellact in resuscitation,and explore the pathogenesis of kidney hurt.Methods:To select twenty-six suffers remedied successfully in Department of acute&other division,China-Japan Union Hospital,jilin Univer- sity,they were all recovered heart ample more twenty-four hours And todemand life support in step,they were all mathing the diagnostic criteria of the cardiac arrest.To detect the changes level of index in different time after CPR.The data measured in different time were in GroupB,C,D,E,F;according to different CA time to divide twenty-six suffersInto two sets.The index measured according to CA time belonging four toEleven minutes and twelve to twenty-eight minutes were Group B1,C1,D1,E1,F1 and B2,C2,D2,E2,F2.The control group selected healthy examination twenty-six man in clinic serice were in Group A,to remove blood rheologyIndex difference between man&woman and different ages.After examiningBUN,SCR,PRO,WBC,TNF-a,IL-1 and the blood cell number of urine in different Group,we anlalysis all datum between group A and B,A and C,A and D,A and E,A and F.B1 and B2,C1 and C2,D1 and D2,E1 and E2,F1 and F2.Then computeand compare the positive rate of PRO in different group,calculate date used mean±standard deviation (x±s)to express,making use of spssv10.0 statistics package to deal.Result:compared group A and B,the result about WBC,TNF-a,IL-1 have statistic meaning.The index of WBC,TNF-a,IL-1 all step up in CPR six hours..The result about BUN,SCR,RBC of urine have no statistic meaning,the index of BUN,SCR,RBC of urine not step up evidently in CPR successfully earlier period.Compared A and C,every index have statistic meaning,the index of BUN,SCR,WBC,TNF-a,IL-1,RBC of urine step up evidently attwenty-four hour after CPR.Compare A and D,all index have statistic meaning,the index of BUN,SCR,WBC,TNF-a,IL-1,RBC of urine step up evidently at forty-eight hour after CPR.Compare A and E,every index have statistic meaning except the index of IL-1, the index of BUN,SCR,WBC,TNF-a,RBC of urine still step up evidently at seventy-two hour after CPR.Inflammatory of IL-1 have no statistic meaning.The index of IL-1 recovers normol value essentially,not express to step up evidently.Compared A and F,the index of the blood cell number of urine have statistic Meaning,it denmonstats the RBC of urine still step up invariably in a week after CPR.The index of BUN,SCR,WBC,TNF-a,IL-1 have no statistic meaning,The index of BUN,SCR,WBC,TNF-a,IL-1 recover normol value essentially after CPR in a week.Compared B1 and B2,C1 and C2,D1 and D2,E1 and E2,F1 and F2,every index have statistic meaning except the index of WBC.The index of BUN,SCR,TNF-a,IL-1,RBC of urine in group B2,C2,D2,E2 and F2 is higher than the index were in group B1,C1,D1,E1,F1.But,the index of WBC have no statistic meaning,it step up almost equal in different time section.Compared A and C,A and D,A and E,A and F.The index of the positive rate of PRO all have statistic meaning. Compared A and B,the index of the positive rate of PRO have no statistic meaning.have no obviously variability,it denmonstats the positive rate of PRO between suffers and normol control have no obviously variability in six hours in CPR earlier periodConclusion:Through examing case of a disease and detecting the index can discern:at CPR earlier period,the cell and tissue of kidney have been infestated,to result some damage relativly,we can see some inflammatory factor have participated earlier damage process of kidney rhagiocrine cell in six hours.because a lot of inflammatory of TNF-a,IL-1 act generated in ischemic reperfusion after CPR to damage kidney.So,for preventing and diminishing the damge of kindeny after CPR,we can detect the TNF-a,IL-1 of suffers to judge the earlier period damge of kidney.We observed the seriously macroscopic damage of kidney mostly at twenty-four hour to seventy-two hour.The kidney damage all can recover among bulk of suffers in a week after CPR,some even can recover normal.Then along CA time last longer,the kidney damage expressed more seriously in different time section kidney function recovered sloq-moving, kidney function almost recovered normal little in a week,some even formed kidney damage forever.Analysis the mechanism of kidney damage after resustation:One aspect is that kidney tissueischemic,anoxaemia,renal blood flow reduced suddenly,endothelial cell of capillary endothelium damaged,permeability of filter membrance increased,acute tubular necrosis and multiplicity cast formded,osmotic pressure gradient of kidney medulla damaged.