中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2012年
5期
437-439
,共3页
多处创伤%血液凝固%血栓调节蛋白%蛋白C
多處創傷%血液凝固%血栓調節蛋白%蛋白C
다처창상%혈액응고%혈전조절단백%단백C
Multiple trauma%Blood coagulation%Thrombomodulin%Protein C
目的 探讨严重创伤患者早期凝血功能变化及与血浆血栓调节蛋白(thrombomodu1in,TM)、蛋白C水平的关系及其临床意义. 方法 选择早期多发伤患者64例,按严重创伤程度评分( ISS)分为重伤组(ISS≥16分)和轻伤组(ISS＜ 16分),比较分析各组凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)变化,同时检测血浆TM和蛋白C水平,分析与凝血功能变化的相关性.另选择30例健康人为正常对照组.比较分析死亡和生存患者血浆TM和蛋白C水平的变化. 结果 重伤组PT和APTT较轻伤组及正常对照组明显延长(P＜0.05),与血浆TM和蛋白C的水平变化均有明显的相关性(P＜0.05).死亡患者血浆TM水平明显高于生存患者,蛋白C明显低于生存患者. 结论 严重创伤患者早期出现凝血功能异常,与血浆TM和蛋白C的活化相关,血浆TM和蛋白C水平对预后有重要的预测价值.
目的 探討嚴重創傷患者早期凝血功能變化及與血漿血栓調節蛋白(thrombomodu1in,TM)、蛋白C水平的關繫及其臨床意義. 方法 選擇早期多髮傷患者64例,按嚴重創傷程度評分( ISS)分為重傷組(ISS≥16分)和輕傷組(ISS＜ 16分),比較分析各組凝血酶原時間(PT)、活化部分凝血酶原時間(APTT)變化,同時檢測血漿TM和蛋白C水平,分析與凝血功能變化的相關性.另選擇30例健康人為正常對照組.比較分析死亡和生存患者血漿TM和蛋白C水平的變化. 結果 重傷組PT和APTT較輕傷組及正常對照組明顯延長(P＜0.05),與血漿TM和蛋白C的水平變化均有明顯的相關性(P＜0.05).死亡患者血漿TM水平明顯高于生存患者,蛋白C明顯低于生存患者. 結論 嚴重創傷患者早期齣現凝血功能異常,與血漿TM和蛋白C的活化相關,血漿TM和蛋白C水平對預後有重要的預測價值.
목적 탐토엄중창상환자조기응혈공능변화급여혈장혈전조절단백(thrombomodu1in,TM)、단백C수평적관계급기림상의의. 방법 선택조기다발상환자64례,안엄중창상정도평분( ISS)분위중상조(ISS≥16분)화경상조(ISS＜ 16분),비교분석각조응혈매원시간(PT)、활화부분응혈매원시간(APTT)변화,동시검측혈장TM화단백C수평,분석여응혈공능변화적상관성.령선택30례건강인위정상대조조.비교분석사망화생존환자혈장TM화단백C수평적변화. 결과 중상조PT화APTT교경상조급정상대조조명현연장(P＜0.05),여혈장TM화단백C적수평변화균유명현적상관성(P＜0.05).사망환자혈장TM수평명현고우생존환자,단백C명현저우생존환자. 결론 엄중창상환자조기출현응혈공능이상,여혈장TM화단백C적활화상관,혈장TM화단백C수평대예후유중요적예측개치.
Objective To investigate the early change of blood coagulation in severe trauma patients and its relationship with plasma levels of thrombomodulin (TM) and protein C. Methods Sixtyfour multiple trauma patients early admitted to the emergency department were divided into two groups according to the injury severity score ( ISS),severe trauma group ( ISS≥16 points) and slight trauma group ( ISS ＜ 16 points).Blood specimens were obtained immediately upon their arrival at hospital to comparatively analyze the changes of prothrombin time (PT) and activated partial thromboplastin time (APTT) in both groups.Meanwhile,plasma levels of TM and protein C were measured and analyzed for discussing their relationship with changes of blood coagulation.Another 30 healthy persons were taken as the control group.Levels of plasma TM and protein C between the death and survival were comparatively analyzed as well. Results PT and APTT in the severe traunma group (ISS ≥ 16 points) were significantly longer than those in the slight trauma group ( ISS ＜ 16 points) and the control group ( P ＜ 0.05 ),with significant correlation with plasma TM and protein C levels ( P ＜ 0.05 ).Plasma TM level in the death group was significantly higher than that in the survival group,but protein C level in the death group was significantly lower than that in the survival group. Conclusions Coagulation abnormalities presenting early after severe trauma are correlated with activation of plasma TM and protein C.Levels of plasma TM and protein C demonstrate significant role in prediction of the prognosis in patients with severe trauma.
