国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2013年
8期
526-529
,共4页
李志伟%王著军%徐旭%郭雅琼%梁永刚%乔帅%马之嘉%孙瑾
李誌偉%王著軍%徐旭%郭雅瓊%樑永剛%喬帥%馬之嘉%孫瑾
리지위%왕저군%서욱%곽아경%량영강%교수%마지가%손근
重症胸腹损伤%凝血功能障碍%肿瘤坏死因子-α%内毒素类%白细胞介素-6%血小板活化因子
重癥胸腹損傷%凝血功能障礙%腫瘤壞死因子-α%內毒素類%白細胞介素-6%血小闆活化因子
중증흉복손상%응혈공능장애%종류배사인자-α%내독소류%백세포개소-6%혈소판활화인자
Severe chest-abdomen injury%Acute coaguiopathy%Tumor necrosis factor-α%Endotoxins%Interleukin-6%Platelet activating factor
目的 探讨肿瘤坏死因子-α(TNF-α)、内毒素(LPS)、白细胞介素-6(IL-6)和血小板活化因子(PAF)与重症胸腹创伤后凝血功能障碍的相关性与机制.方法 收集2009年1月-2012年6月在解放军第二五三医院急诊科就诊,创伤指数(TI)≥17分,排除合并颅脑损伤及在急诊死亡的胸腹创伤患者82例,在救治同时抽血检查血小板计数(PLT)、部分活化凝血酶原时间(APPT)、凝血酶原时间(PT)、TNF-α、LPS、IL-6、PAF,对检验结果行相关性分析.结果 凝血功能检验结果:PLT:(83.44±38.52)×109/L),APTT:(68.24 ±24.12)S,PT:(28.42±10.83)S；损伤因子检测结果:TNF-α:(36.41±18.09) ng/mL,LPS:(343.66±106.02) IU/L,IL-6:(393.83±143.86) ng/mL,PAF:(15765.31±4431.65) ng/L.PLT与TNF-α、LPS、IL-6、PAF之间相关系数(r)均小于-0.8811,呈显著负相关.APTT、PT与TNF-α、LPS、IL-6、PAF之间r均大于0.9142,呈显著正相关.结论 TNF-α、LPS、IL-6、PAF可能参与了重症胸腹创伤凝血功能障碍的发生过程,对TNF-α、LPS、IL-6、PAF早期干预,或可改善胸腹创伤患者的凝血功能障碍.
目的 探討腫瘤壞死因子-α(TNF-α)、內毒素(LPS)、白細胞介素-6(IL-6)和血小闆活化因子(PAF)與重癥胸腹創傷後凝血功能障礙的相關性與機製.方法 收集2009年1月-2012年6月在解放軍第二五三醫院急診科就診,創傷指數(TI)≥17分,排除閤併顱腦損傷及在急診死亡的胸腹創傷患者82例,在救治同時抽血檢查血小闆計數(PLT)、部分活化凝血酶原時間(APPT)、凝血酶原時間(PT)、TNF-α、LPS、IL-6、PAF,對檢驗結果行相關性分析.結果 凝血功能檢驗結果:PLT:(83.44±38.52)×109/L),APTT:(68.24 ±24.12)S,PT:(28.42±10.83)S；損傷因子檢測結果:TNF-α:(36.41±18.09) ng/mL,LPS:(343.66±106.02) IU/L,IL-6:(393.83±143.86) ng/mL,PAF:(15765.31±4431.65) ng/L.PLT與TNF-α、LPS、IL-6、PAF之間相關繫數(r)均小于-0.8811,呈顯著負相關.APTT、PT與TNF-α、LPS、IL-6、PAF之間r均大于0.9142,呈顯著正相關.結論 TNF-α、LPS、IL-6、PAF可能參與瞭重癥胸腹創傷凝血功能障礙的髮生過程,對TNF-α、LPS、IL-6、PAF早期榦預,或可改善胸腹創傷患者的凝血功能障礙.
목적 탐토종류배사인자-α(TNF-α)、내독소(LPS)、백세포개소-6(IL-6)화혈소판활화인자(PAF)여중증흉복창상후응혈공능장애적상관성여궤제.방법 수집2009년1월-2012년6월재해방군제이오삼의원급진과취진,창상지수(TI)≥17분,배제합병로뇌손상급재급진사망적흉복창상환자82례,재구치동시추혈검사혈소판계수(PLT)、부분활화응혈매원시간(APPT)、응혈매원시간(PT)、TNF-α、LPS、IL-6、PAF,대검험결과행상관성분석.결과 응혈공능검험결과:PLT:(83.44±38.52)×109/L),APTT:(68.24 ±24.12)S,PT:(28.42±10.83)S；손상인자검측결과:TNF-α:(36.41±18.09) ng/mL,LPS:(343.66±106.02) IU/L,IL-6:(393.83±143.86) ng/mL,PAF:(15765.31±4431.65) ng/L.PLT여TNF-α、LPS、IL-6、PAF지간상관계수(r)균소우-0.8811,정현저부상관.APTT、PT여TNF-α、LPS、IL-6、PAF지간r균대우0.9142,정현저정상관.결론 TNF-α、LPS、IL-6、PAF가능삼여료중증흉복창상응혈공능장애적발생과정,대TNF-α、LPS、IL-6、PAF조기간예,혹가개선흉복창상환자적응혈공능장애.
Objective To investigate the correlation between tumor necrosis factor-α (TNF-α)、lipopolysaccharide (LPS) 、interleukin-6 (IL-6) and platelet activating factor (PAF) with the blood coagulation function disorder in severe chest-abdominal injury and to study the effect of these factors on it.Methods Eighty-two cases with severe chest-abdominal injury were collected in the 253th Hospital of PLA from January in 2009 to June in 2012,of whom the trauma index were all above or equal to 17 points,and as the rescue and treatment were in progress the patients were examined platelet count (PLT),activated partial thromboplastin time (APTT),prothrombin (PT),TNF-α,LPS,IL-6 and PAF for correlation analysis.Results The blood coagulation function examined results:PLT:83.44 ± 38.52 (109/L),APTT:68.24 ± 24.12 (s),PT:28.42 ± 10.83 (s) ; Injury factors examined results:TNF-α:36.41 ± 18.09 (ng/ml) ; LPS:343.66 ± 106.02 (IU/L) ; IL-6:393.83 ± 143.86 (ng/ml) ; PAF:15765.31 ± 4431.65 (ng/L).There was evedently correlation between the blood coagulation function with injury factors.Conclusion TNF-α,LPS,IL-6 and PAF all may participate in the process of the blood coagulation function disorder in severe chest-abdominal injury.The prophase interference in TNF-o,LPS,IL-6 and PAF is possible to improve the coagulation dysfunction in severe chest-abdominal injury.
