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目的 :探讨严重创伤患者血清胱抑素C(CysC)、脑钠肽(BNP)水平的变化及其临床意义。方法 :选取我院收治的创伤严重程度评分(ISS)≥25分的严重创伤患者60例,根据患者是否休克分为A1组(休克31人)与A2组(非休克29人);是否合并颅脑损伤分为A3组(伴颅脑30人)与A4组(不伴颅脑30人);是否死亡分为A5组(死亡18人)与A6组(生存42人)。观察比较各组患者入院第1、3、7天BNP、CysC、肌酐水平变化。结果 :死亡组各时点的CysC、BNP、血肌酐水平均显著高于存活组;伴颅脑损伤组与无颅脑损伤组各时点CysC、血肌酐水平均无明显差别,第3天BNP水平有显著差异;休克组与非休克组第1、3、7天血肌酐水平均有显著差异,第1天CysC水平有显著差异,第7天BNP水平有显著差异;死亡组入院24小时内APACHEⅡ评分显著高于生存组。结论 :严重创伤患者的病情与BNP、CysC水平密切相关,BNP、CysC水平升高提示其预后不佳,检测BNP、CysC可作为病情监测的有效指标,对临床治疗具有一定的参考指导价值。
Objective: To investigate the changes of serum cystatin C (CysC) and brain natriuretic peptide (BNP) in patients with severe trauma and its clinical significance. Methods: 60 severe traumatic patients with traumatic severity score (ISS) ≥25 were selected in our hospital. According to whether the patients were shocked, the patients were divided into A1 group (31 in shock group) and A2 group (29 in non-shock group) The brain injury was divided into A3 group (30 with cranial brain) and A4 group (30 without cranial brain); whether death was divided into A5 group (18 deaths) and A6 group (42 survival). The changes of BNP, CysC and creatinine were observed on the 1st, 3rd, 7th day after admission in each group. Results: The levels of CysC, BNP and serum creatinine were significantly higher in survivors than those in survivors. The levels of CysC and serum creatinine in traumatic brain injury group were not significantly different from those in non-traumatic brain injury group. On the third day, BNP There was a significant difference in serum creatinine level between the shock group and the non-shock group on the 1st, 3rd, 7th day. There was a significant difference of CysC level on the first day and significant difference on the 7th day. The death group within 24 hours APACHE Ⅱ score was significantly higher than the survival group. CONCLUSIONS: Serious trauma patients are closely related to BNP and CysC levels. The elevated BNP and CysC levels indicate that their prognosis is poor. BNP and CysC can be used as effective indicators for disease surveillance, which may provide some reference value for clinical treatment.