CAJ | 학술논문

目的：探讨交通伤患者血清肌酸激酶（ CK）动态变化对病情严重程度及预后的评估价值。方法选取2012年6月—2013年7月于新疆医科大学第一附属医院治疗的交通伤患者61例为研究对象。根据患者是否发生院内死亡，分为死亡组（16例）和存活组（45例）；另根据患者损伤严重度评分（ ISS），分为重伤组（ ISS≥25分，38例）和轻伤组（ ISS <25分，23例）。结果患者交通伤后第1、2、5天血清 CK 水平分别为1360（261）、1520（172）、540（496）U/L，患者不同时间CK水平比较，差异有统计学意义（H=36.029，P<0.05），其中第2天CK水平高于第1、5天，差异有统计学意义（ H=59.314、51.209，P<0.018）。死亡组第1天CK水平低于存活组，第2、5天CK水平高于存活组，差异有统计学意义（ P<0.05）。死亡组患者第1、2、5天血清CK水平比较，差异有统计学意义（H=9.414，P<0.05），其中，第2、5天血清CK水平高于第1天，差异有统计学意义（H=18.146、23.186， P<0.018）。重伤组第1、2、5天血清CK水平均高于轻伤组，差异有统计学意义（ H=11.235、15.556、22.705，P<0.05）。结论血清CK水平的动态变化与患者受伤严重程度有关，可作为评估交通伤患者病情严重程度和预后的临床检测指标。
목적：탐토교통상환자혈청기산격매（ CK）동태변화대병정엄중정도급예후적평고개치。방법선취2012년6월—2013년7월우신강의과대학제일부속의원치료적교통상환자61례위연구대상。근거환자시부발생원내사망，분위사망조（16례）화존활조（45례）；령근거환자손상엄중도평분（ ISS），분위중상조（ ISS≥25분，38례）화경상조（ ISS <25분，23례）。결과환자교통상후제1、2、5천혈청 CK 수평분별위1360（261）、1520（172）、540（496）U/L，환자불동시간CK수평비교，차이유통계학의의（H=36.029，P<0.05），기중제2천CK수평고우제1、5천，차이유통계학의의（ H=59.314、51.209，P<0.018）。사망조제1천CK수평저우존활조，제2、5천CK수평고우존활조，차이유통계학의의（ P<0.05）。사망조환자제1、2、5천혈청CK수평비교，차이유통계학의의（H=9.414，P<0.05），기중，제2、5천혈청CK수평고우제1천，차이유통계학의의（H=18.146、23.186， P<0.018）。중상조제1、2、5천혈청CK수평균고우경상조，차이유통계학의의（ H=11.235、15.556、22.705，P<0.05）。결론혈청CK수평적동태변화여환자수상엄중정도유관，가작위평고교통상환자병정엄중정도화예후적림상검측지표。
Objective To study the evaluation value of dynamic changes of the serum creatine kinase( CK)in traffic injury patients on injury condition and prognosis. Methods We enrolled 61 traffic injury patients who were admitted into the First Affiliated Hospital of Xinjiang medical University from June 2012 to July 2013. The subjects were divided into death group (n=16)and survival group(n=45)according to death or survival and were also divided into severe injury group(n=38,ISS≥25)and slight injury group(n=23,ISS<25)according to ISS score. Results The level of serum CK of the subjects on day 1,day 2 and day 5 were 1 360(261),1 520(172)and 540(496)U/L. The subjects had significant different CK levels(H=36. 029,P<0. 05)at different time points,with the CK level of day 2 higher than that on day 1 and day 5(H=59. 314,51. 209;P<0. 018). The death group was lower(P<0. 05)than the survival group in CK level on day 1 and were higher(P<0. 05)than the survival group in CK level on day 2 and day 5. The death group had significantly different CK levels (H=9. 414,P<0. 05)on day 1,day 2 and day 5,with the serum CK levels on day 2 and day 5 higher than that on day 1(H=18. 146,23. 186;P<0. 018). The severe injury group was higher than the slight injury group in serum CK level on day 1, day 2 and day 5 ( H =11. 235,15. 556,22. 705;P <0. 05 ). Conclusion The dynamic changes of serum CK level are related with the severity degree of traffic injury patients and can be used as the clinical indicators of injury severity and prognosis of traffic injury patients.