多发伤患者血清中肌红蛋白、肌酸激酶和相关炎性介质的表达及临床意义

发布时间：2018-06-25 23:30

本文选题：多发伤 + 肌红蛋白　；参考：《中国呼吸与危重监护杂志》2017年01期

【摘要】：目的探讨血清肌红蛋白(Mb)、肌酸激酶(CK)和相关炎性介质在多发伤患者血清中的动态表达及其临床意义。方法将2013年5月至2015年3月在我院急诊重症监护室(EICU)住院治疗的多发伤患者56例作为研究组,并根据入院伤情进一步分为轻度创伤组(n=16)、中度创伤组(n=29)、重度创伤组(n=11),动态观察多发伤患者病情变化情况。根据多器官功能障碍综合征(MODS)评判标准,将56例患者分为MODS组(n=19)和非MODS组(n=37)。分别对各组患者伤后第1、3、7、14 d血清Mb、CK、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)进行检测。同法测定20例健康体检者血清相应指标作为对照。结果与对照组比较,多发伤患者血清Mb、CK、IL-6和TNF-α水平在伤后第1、3、7、14 d均显著升高(P0.05)。多发伤轻、中、重度创伤组血清Mb、CK、IL-6和TNF-α水平在伤后第3 d升至高峰,随后逐渐下降。其中血清Mb、CK、IL-6和TNF-α水平在第3 d时与同组间不同时段比较,差异有统计学意义(P0.05)。在伤后第1 d,患者血清Mb、CK、IL-6和TNF-α水平水平在MODS组和非MODS组亦有显著差异(P0.05)。Mb、IL-6和TNF-α判断MODS的ROC曲线下面积(AUC)分别为0.527~0.817、0.641~0.890、0.197~0.544。结论 Mb、CK、IL-6和TNF-α的动态变化与多发伤患者病情严重程度、变化趋势及预后具有一定相关性。多发伤患者血清Mb、IL-6和TNF-α水平增高对预测继发性MODS有一定价值。
[Abstract]:Objective to explore the dynamic expression and clinical significance of serum myoglobin (Mb), creatine kinase (CK) and related inflammatory mediators in the serum of patients with multiple injuries. Methods 56 patients with multiple injuries hospitalized in the emergency intensive care unit (EICU) in our hospital from May 2013 to March 2015 were selected as the study group and were further divided into mild cases according to the hospitalized conditions. 56 patients were divided into MODS group (n=19) and non MODS group (n=37) according to the criteria of multiple organ dysfunction syndrome (MODS), and 56 patients were divided into MODS group (n=19) and non MODS group (n=37). The serum Mb, CK, interleukin, and tumor were bad for the patients in each group. Death factor - alpha (TNF- alpha) was tested. Compared with the control group, the serum levels of Mb, CK, IL-6 and TNF- alpha in the patients with multiple injuries were significantly increased in 1,3,7,14 d after injury (P0.05). The serum Mb, CK, IL-6, and TNF- alpha levels in the severe trauma group rose to third after the injury. The levels of serum Mb, CK, IL-6 and TNF- alpha were compared with the same group at third D, and the difference was statistically significant (P0.05). The level of serum Mb, CK, IL-6 and TNF- alpha at first d after injury. The dynamic changes of 0.527~0.817,0.641~0.890,0.197~0.544. Mb, CK, IL-6 and TNF- alpha were related to the severity, the trend and the prognosis of the patients with multiple injuries. The serum levels of Mb, IL-6 and TNF- alpha in the patients with multiple injuries were of certain value for the prediction of secondary MODS.
【作者单位】：镇江市第一人民医院急诊外科;镇江市第一人民医院重症医学科;

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