院外心脏骤停（OHCA）后的心脏骤停后综合征（PCAS）的特点是一系列病理事件，包括炎症。在随机“类固醇治疗 OHCA”(STEROHCA) 试验中，院前大剂量糖皮质激素可降低 OHCA 复苏后的白细胞介素 (IL) 6 和 C 反应蛋白水平。这项预先确定的子研究的目的是评估入院前三天的炎症反应。STEROHCA 试验招募了 137 名 OHCA 患者，随机接受院前单次注射甲泼尼龙 250 毫克或安慰剂。对入院后 0、24、48 和 72 小时的血浆样本中的炎症标志物（包括促炎细胞因子和抗炎细胞因子）进行了分析。使用对数转换数据应用混合模型分析来评估组间差异。这项子研究中纳入的 137 名患者的中位年龄为 67 岁（57 至 74 岁），180 天生存率为 75%（n = 51/68) 和 64% (n = 44/69) 分别在糖皮质激素组和安慰剂组中。总共 130 名 (95%) 患者至少有一份可用血浆样本。糖皮质激素组入院时抗炎细胞因子 IL-10 升高（比率 2.74 (1.49-5.05)，p = 0.006），但干预 24 小时后效果最强，降低了 IL-10 的促炎水平。 6（比率 0.06 (0.03-0.10)，p < 0.001），IL-8（比率 0.53 (0.38-0.75），p < 0.001），巨噬细胞趋化因子蛋白-1（MCP-1，比率 0.02 (0.13-0.31)， p < 0.001)、巨噬细胞炎症蛋白-1-β (MIP-1b，比率 0.28 (0.18-0.45)，p < 0.001) 和肿瘤坏死因子-α (TNF-α，比率 0.6 (0.4-0.8)，p = 0.01)。OHCA 复苏后立即给予高剂量糖皮质激素治疗会影响炎症反应，24 小时后几种全身促炎细胞因子减少。EudraCT 编号：2020-000855-11；提交日期：2020 年 3 月 30 日。网址：https://www.gov；唯一标识符：NCT04624776。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

The post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA) is characterized by a series of pathological events, including inflammation. In the randomized "STERoid for OHCA" (STEROHCA) trial, prehospital high-dose glucocorticoid decreased interleukin (IL) 6 and C-reactive protein levels following resuscitated OHCA. The aim of this predefined sub-study was to assess the inflammatory response the first three days of admission.The STEROHCA trial enrolled 137 OHCA patients randomized to either a single prehospital injection of methylprednisolone 250 mg or placebo. Inflammatory markers, including pro- and anti-inflammatory cytokines, were analyzed in plasma samples, from 0-, 24-, 48-, and 72 h post-admission. Mixed-model analyses were applied using log-transformed data to assess group differences.The 137 patients included in this sub-study had a median age of 67 years (57 to 74), and the 180-day survival rates were 75% (n = 51/68) and 64% (n = 44/69) in the glucocorticoid and placebo group, respectively. A total of 130 (95%) patients had at least one plasma sample available. The anti-inflammatory cytokine IL-10 was increased at hospital admission in the glucocorticoid group (ratio 2.74 (1.49-5.05), p = 0.006), but the intervention showed the strongest effect after 24 h, decreasing pro-inflammatory levels of IL-6 (ratio 0.06 (0.03-0.10), p < 0.001), IL-8 (ratio 0.53 (0.38-0.75), p < 0.001), macrophage chemokine protein-1 (MCP-1, ratio 0.02 (0.13-0.31), p < 0.001), macrophage inflammatory protein-1-beta (MIP-1b, ratio 0.28 (0.18-0.45), p < 0.001), and tumor necrosis factor-α (TNF-α, ratio 0.6 (0.4-0.8), p = 0.01).Administering high-dose glucocorticoid treatment promptly after resuscitation from OHCA influenced the inflammatory response with a reduction in several systemic proinflammatory cytokines after 24 h.EudraCT number: 2020-000855-11; submitted March 30, 2020. URL: https://www.gov; Unique Identifier: NCT04624776.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.