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-  2017 

多发伤患者血清中肌红蛋白、肌酸激酶和相关炎性介质的表达及临床意义

DOI: doi:10.7507/1671-6205.201606035

Keywords: 多发伤, 肌红蛋白, 肌酸激酶, 炎性介质, 多器官功能障碍

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Abstract:

目的 探讨血清肌红蛋白(Mb)、肌酸激酶(CK)和相关炎性介质在多发伤患者血清中的动态表达及其临床意义。 方法 将 2013 年 5 月至 2015 年 3 月在我院急诊重症监护室(EICU)住院治疗的多发伤患者 56 例作为研究组,并根据入院伤情进一步分为轻度创伤组( n=16)、中度创伤组( n=29)、重度创伤组( n=11),动态观察多发伤患者病情变化情况。根据多器官功能障碍综合征(MODS)评判标准,将 56 例患者分为 MODS 组( n=19)和非 MODS 组( n=37)。分别对各组患者伤后第 1、3、7、14 d 血清 Mb、CK、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)进行检测。同法测定 20 例健康体检者血清相应指标作为对照。 结果 与对照组比较,多发伤患者血清 Mb、CK、IL-6 和 TNF-α 水平在伤后第 1、3、7、14 d 均显著升高( P<0.05)。多发伤轻、中、重度创伤组血清 Mb、CK、IL-6 和 TNF-α 水平在伤后第 3 d 升至高峰,随后逐渐下降。其中血清 Mb、CK、IL-6 和 TNF-α 水平在第 3 d 时与同组间不同时段比较,差异有统计学意义( P<0.05)。在伤后第 1 d,患者血清 Mb、CK、IL-6 和 TNF-α 水平水平在 MODS 组和非 MODS 组亦有显著差异( P<0.05)。Mb、IL-6 和 TNF-α 判断 MODS 的 ROC 曲线下面积(AUC)分别为 0.527~0.817、0.641~0.890、0.197~0.544。 结论 Mb、CK、IL-6 和 TNF-α 的动态变化与多发伤患者病情严重程度、变化趋势及预后具有一定相关性。多发伤患者血清 Mb、IL-6 和 TNF-α 水平增高对预测继发性 MODS 有一定价值

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