多处创伤%肌红蛋白%肌酸激酶%肾功能衰竭,慢性
多處創傷%肌紅蛋白%肌痠激酶%腎功能衰竭,慢性
다처창상%기홍단백%기산격매%신공능쇠갈,만성
Multiple trauma%Myoglobin%Creatine kinase%Kidney failure,chronic
目的 观察多发伤患者血清肌红蛋白(myoglobin,Mb)和肌酸激酶(creatine kinase,CK)水平与患者预后及肾功能衰竭的关系,比较两者在预后判断中的价值. 方法 检测41例多发伤患者(ISS≥16分)伤后1,3,7,14 d血清Mb及CK浓度,同时记录伤后1d简化急性生理评分Ⅱ(simplified acute physiology scoreⅡ,SAPSⅡ)、ISS、GCS,以及最终转归和有无发生肾功能衰竭.分析血清Mb、CK浓度与ISS、GCS、SAPSⅡ的相关性.使用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析并比较伤后1,3,7dMb及CK在预测多发伤患者转归及发生肾功能衰竭中的价值. 结果 血清Mb浓度在各时相点与SAPSⅡ均呈正相关,与ISS在7,14d呈正相关,而与GCS在3,7,14 d呈负相关;血清CK浓度在3,7,14 d与SAPSⅡ呈正相关,与ISS在7,14 d呈正相关,与GCS在7,14 d呈负相关.在用ROC判断患者预后中,伤后1,3,7d的血清Mb的曲线下面积分别为0.542,0.900,0.981;CK的曲线下面积分别为0.232,0.771,0.968.用ROC判断患者发生肾功能衰竭中,伤后1,3,7d的血清Mb的曲线下面积分别为0.864,0.949,0.955;CK的曲线下面积分别为0.480,0.889,0.939. 结论 血清Mb和CK在判断患者预后及发生肾功能衰竭时均有较好的价值,其中血清Mb的价值更高.
目的 觀察多髮傷患者血清肌紅蛋白(myoglobin,Mb)和肌痠激酶(creatine kinase,CK)水平與患者預後及腎功能衰竭的關繫,比較兩者在預後判斷中的價值. 方法 檢測41例多髮傷患者(ISS≥16分)傷後1,3,7,14 d血清Mb及CK濃度,同時記錄傷後1d簡化急性生理評分Ⅱ(simplified acute physiology scoreⅡ,SAPSⅡ)、ISS、GCS,以及最終轉歸和有無髮生腎功能衰竭.分析血清Mb、CK濃度與ISS、GCS、SAPSⅡ的相關性.使用受試者工作特徵麯線(receiver operating characteristic curve,ROC)分析併比較傷後1,3,7dMb及CK在預測多髮傷患者轉歸及髮生腎功能衰竭中的價值. 結果 血清Mb濃度在各時相點與SAPSⅡ均呈正相關,與ISS在7,14d呈正相關,而與GCS在3,7,14 d呈負相關;血清CK濃度在3,7,14 d與SAPSⅡ呈正相關,與ISS在7,14 d呈正相關,與GCS在7,14 d呈負相關.在用ROC判斷患者預後中,傷後1,3,7d的血清Mb的麯線下麵積分彆為0.542,0.900,0.981;CK的麯線下麵積分彆為0.232,0.771,0.968.用ROC判斷患者髮生腎功能衰竭中,傷後1,3,7d的血清Mb的麯線下麵積分彆為0.864,0.949,0.955;CK的麯線下麵積分彆為0.480,0.889,0.939. 結論 血清Mb和CK在判斷患者預後及髮生腎功能衰竭時均有較好的價值,其中血清Mb的價值更高.
목적 관찰다발상환자혈청기홍단백(myoglobin,Mb)화기산격매(creatine kinase,CK)수평여환자예후급신공능쇠갈적관계,비교량자재예후판단중적개치. 방법 검측41례다발상환자(ISS≥16분)상후1,3,7,14 d혈청Mb급CK농도,동시기록상후1d간화급성생리평분Ⅱ(simplified acute physiology scoreⅡ,SAPSⅡ)、ISS、GCS,이급최종전귀화유무발생신공능쇠갈.분석혈청Mb、CK농도여ISS、GCS、SAPSⅡ적상관성.사용수시자공작특정곡선(receiver operating characteristic curve,ROC)분석병비교상후1,3,7dMb급CK재예측다발상환자전귀급발생신공능쇠갈중적개치. 결과 혈청Mb농도재각시상점여SAPSⅡ균정정상관,여ISS재7,14d정정상관,이여GCS재3,7,14 d정부상관;혈청CK농도재3,7,14 d여SAPSⅡ정정상관,여ISS재7,14 d정정상관,여GCS재7,14 d정부상관.재용ROC판단환자예후중,상후1,3,7d적혈청Mb적곡선하면적분별위0.542,0.900,0.981;CK적곡선하면적분별위0.232,0.771,0.968.용ROC판단환자발생신공능쇠갈중,상후1,3,7d적혈청Mb적곡선하면적분별위0.864,0.949,0.955;CK적곡선하면적분별위0.480,0.889,0.939. 결론 혈청Mb화CK재판단환자예후급발생신공능쇠갈시균유교호적개치,기중혈청Mb적개치경고.
Objective To detect the correlation of serum myoglobin (Mb) and creatine kinase (CK) levels in multiple trauma patients with outcome and renal failure and compare the prognostic value of the two predictors.Methods Forty-one patients with multiple trauma (ISS ≥ 16 points) were analyzed at days 1,3,7,and 14 posttrauma,for serum Mb and CK concentrations.Moreover,simplified acute physiology score Ⅱ (SAPS Ⅱ),injury severity score (ISS),as well as Glasgow coma score (GCS)at day 1 postrauma,final outcome,and presence or absence of renal failure were recorded.Correlation of serum Mb and CK with ISS,GCS,and SAPS Ⅱ was analyzed.Predictive values of Mb and CK for outcome and development of renal failure after multiple trauma were measured and compared at days 1,3,and 7 posttrauma,according to receiver operating characteristic (ROC) curve.Results Serum Mb concentration revealed a positive correlation with SAPS Ⅱ at each time point and with ISS at days 7 and 14,but a negative correlation with GCS at days 3,7,and 14.Similarly,serum CK concentration presented a positive correlation with SAPS Ⅱ at days 3,7,and 14 and with ISS at days 7 and 14,but a negative correlation with GCS at days 7 and 14.To predict outcome of the multiple trauma patients,area under the ROC curve for serum Mb at days 1,3,and 7 was 0.542,0.900,and 0.981 respectively and for serum CK was 0.232,0.771,and 0.968 respectively.To predict development of renal failure,area under the ROC curve for serum Mb at days 1,3,and 7 was 0.864,0.949,and 0.955 respectively and for serum CK was 0.480,0.889,and 0.939 respectively.Conclusions Serum Mb and CK are both predictive of outcome and development of renal failure following multiple trauma.Whereas in co；rast with CK,serum Mb appears to be a more sensitive marker.
