摘要
目的探讨严重多发伤患者血浆血栓调节蛋白(thrombomodulin,TM)水平变化及与创伤后弥散性血管内凝血(disseminated intravascular coagulation,DIC)之间的关系。方法将66例多发伤患者分为轻伤组(ISS评分<16分)21例和重伤组(ISS评分≥16分)45例,再把重伤患者分为并发DIC组(12例)与未并发DIC组(33例)。另10例健康人为正常对照组。正常对照组采外周静脉血1次,其余组分别于伤后1、3、7d空腹采集外周静脉血,应用ELISA方法测定血浆TM浓度。结果轻伤与重伤组血浆TM水平伤后均明显高于正常对照组,且重伤组又明显高于轻伤组。非DIC组伤后TM水平迅速降低,DIC组TM水平先升高后降低,DIC组的TM水平显著高于非DIC组。结论创伤后急性期TM水平的升高程度不仅与创伤严重程度有关,而且与创伤后DIC的发生显著正相关。因此,测定严重多发伤患者急性期外周血浆TM水平变化对预测创伤后DIC的发生具有一定价值。
Objective To explore the relation between traumatic disseminated intravascular coagulation （DIC） and the level of plasma thrombomodulin （TM） in severe multiple-injury patients. Methods Sixty-six multiple-injury patients were divided into minor-injury group （ISS 〈 16, 21cases） and severe injury group （ISS ≥16, 45 cases）. Then the severe multiple-injury group was subdivided into DIC group （12 cases） and non- DIC group （33 cases）. The other 10 healthy people served as the control group. Venous blood was collected once in the control group and in other groups venous blood was collected on day 1, 3 and 7 after trauma. The TM concentration was determined by ELISA. Results The TM levels of the minor-injury and severe injury groups were higher than those of the control group, and the severe injury group was remarkably higher than the minor-injury group. In the non-DIC group, the TM level continuously declined; while in the DIC group, it rose at first and then decreased remarkably, with the level being remarkably higher in DIC group than non-DIC one. Conclusion TM level is not only relevant to the severity of trauma, but also closely relevant to the occurrence of traumatic DIC after trauma. The detection of plasma TM level can predict the occurrence of DIC.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2007年第7期620-622,共3页
Journal of Third Military Medical University
关键词
多发伤
弥散性血管内凝血
血栓调节蛋白
multiple-injury
disseminated intravascular coagulation
thrombomodulin
