中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2009年
8期
725-728
,共4页
贾叶华%陈心%熊建华%张建宁
賈葉華%陳心%熊建華%張建寧
가협화%진심%웅건화%장건저
脑损伤%血栓形成%炎症%血小板%白细胞
腦損傷%血栓形成%炎癥%血小闆%白細胞
뇌손상%혈전형성%염증%혈소판%백세포
Brain injuries%Thrombosis%Inflammation%Blood platelets%Leukocytes
目的 探明创伤性脑损伤患者白细胞(WBC)、血小板(PLT)的动态变化及临床意义. 方法 采用血细胞分析仪测定63例创伤性脑损伤患者不同时间点的白细胞与血小板数量,并结合GOS、是否合并感染进行比较分析.同时采用ELIISA法观测C反应蛋白(CRP)、凝血酶敏感蛋白1(TSP1)的浓度变化并进行相关分析. 结果 患者是否合并感染WBC在伤后24 h内都显著增高(P<0.01),非感染组患者在4 d时与正常对照组比较,差异无统计学意义(P>0.05),降至10×109/L以下,但感染组患者4 d时仍高于正常(P<0.05).感染及预后不良患者WBC在7～14 d 出现二次升高,PLT在14～21 d显著升高(P<0.01).TSP1的浓度变化与CRP呈正相关关系(r=0.720,P<0.01). 结论 WBC的动态变化为预防性抗生素使用提供依据;感染可能引起患者后期高凝状态,注意监测感染患者14～21 d PLIT的变化;WBC二次升高及PLT后期升高影响患者预后;TSP1与CRP可能参与炎症引发血栓形成的过程.
目的 探明創傷性腦損傷患者白細胞(WBC)、血小闆(PLT)的動態變化及臨床意義. 方法 採用血細胞分析儀測定63例創傷性腦損傷患者不同時間點的白細胞與血小闆數量,併結閤GOS、是否閤併感染進行比較分析.同時採用ELIISA法觀測C反應蛋白(CRP)、凝血酶敏感蛋白1(TSP1)的濃度變化併進行相關分析. 結果 患者是否閤併感染WBC在傷後24 h內都顯著增高(P<0.01),非感染組患者在4 d時與正常對照組比較,差異無統計學意義(P>0.05),降至10×109/L以下,但感染組患者4 d時仍高于正常(P<0.05).感染及預後不良患者WBC在7～14 d 齣現二次升高,PLT在14～21 d顯著升高(P<0.01).TSP1的濃度變化與CRP呈正相關關繫(r=0.720,P<0.01). 結論 WBC的動態變化為預防性抗生素使用提供依據;感染可能引起患者後期高凝狀態,註意鑑測感染患者14～21 d PLIT的變化;WBC二次升高及PLT後期升高影響患者預後;TSP1與CRP可能參與炎癥引髮血栓形成的過程.
목적 탐명창상성뇌손상환자백세포(WBC)、혈소판(PLT)적동태변화급림상의의. 방법 채용혈세포분석의측정63례창상성뇌손상환자불동시간점적백세포여혈소판수량,병결합GOS、시부합병감염진행비교분석.동시채용ELIISA법관측C반응단백(CRP)、응혈매민감단백1(TSP1)적농도변화병진행상관분석. 결과 환자시부합병감염WBC재상후24 h내도현저증고(P<0.01),비감염조환자재4 d시여정상대조조비교,차이무통계학의의(P>0.05),강지10×109/L이하,단감염조환자4 d시잉고우정상(P<0.05).감염급예후불량환자WBC재7～14 d 출현이차승고,PLT재14～21 d현저승고(P<0.01).TSP1적농도변화여CRP정정상관관계(r=0.720,P<0.01). 결론 WBC적동태변화위예방성항생소사용제공의거;감염가능인기환자후기고응상태,주의감측감염환자14～21 d PLIT적변화;WBC이차승고급PLT후기승고영향환자예후;TSP1여CRP가능삼여염증인발혈전형성적과정.
Objective To investigate the dynamic changes of platelets (PLT) and white blood cells (WBC) after traumatic brain injury (TBI) and discuss its clinical significance. Methods The number of PLT and WBC were examined in 63 patients with TBI by using cytoanalyze and also analyzed together with Glasgow Outcome Scale and concurrent infection, in the meantime, enzyme-linked immu-nosorbent was used to investigate concentration changes of C reactive protein (CRP) and thrombospondin 1 (TSPI) and analyze the correlation between CRP and TSP1. Results The number of WBC in all pa-tients, whether concurred with infection or not, was significantly increased within 24 hours after TBI (P < 0.01), with no statistical difference between patients without infection at day 4 and normal patients (P >0.05). However, the number of WBC was decreased to below 10 × 109/L in patients without infec-tion, which was significantly higher than that in normal patients (P < 0.05). In patients with infection and unfavorable prognosis, the number of WBC was increased again ay days 7-14, whereas that of PLT rose significantly at days 14-21 (P <0. 01). The concentration of TSPI was positively correlated with that of CRP (r = 0.720, P < 0.01). Conclusions Monitoring the dynamic changes of PLT and WBC is promising. The change of WBC at day 4 post injury is a key indicator to provide evidences of prophylactic antibiotic usage. Much attention should be paid to the dynamic change of PLT at days 14-21 post injury so as to evaluate the condition of hypercoagulability that can be potentially caused by inflammation response. Secondary increase of WBC and later increase, of PLT may affect prognosis of the patients. TSP1 and CRP may participate in thrombosis formation induced by inflammation.
