摘要
目的探讨肿瘤坏死因子-α（TNF-α）、内毒素（LPS）、白细胞介素-6（IL-6）和血小板活化因子（PAF）与颅脑损伤急性凝血功能障碍的相关性。方法 2009年1月~2012年6月收治创伤指数≥17分、GCS评分≤10分、无其它部位损伤的颅脑损伤患者65例（颅脑损伤组）,在救治同时行血小板计数（PLT）、血浆D-二聚体（D-D）、部分活化凝血酶原时间（APPT）等检查,并与TNF-α、LPS、IL-6、PAF的检测结果进行相关性分析。另选择同期我院体检健康成年人43例作为对照组。结果与对照组相比,颅脑损伤患者PLT明显降低（P〈0.05）,而血浆D-D、APPT、TNF-α、LPS、IL-6和PAF均显著增高（P〈0.01）。颅脑损伤患者PLT与TNF-α、LPS、IL-6、PAF均呈显著负相关（P〈0.01）;D-D、APTT与TNF-α、LPS、IL-6、PAF均呈显著正相关（P〈0.01）。结论TNF-α、LPS、IL-6、PAF可能参与颅脑损伤后急性凝血功能障碍的发生。颅脑损伤后早期TNF-α、LPS、IL-6、PAF进行干预,可改善凝血功能障碍。
Objective To study the correlativity of tumor necrosis factor-a （TNF-a）, lipopolysaccharide （LPS）, interleukin-6 （IL-6） and platelet activating factor （PAF） with the blood coagulation function disorder in the patients with traumatic brain injury （TBI）. Methods The platelet count （PLT） and the content of D-dimer （D-D）, activated partial thromboplastin time （APTT）, TNF-a, LPS, IL-6 and PAF in the blood were determined on admission to hospital in 65 patients with TBI, who had trauma index ≥ 17 points and GCS 10 points, from January, 2009 to June, 2012 and the normal heahhful subjects who served as control. Results PLT [（74.91±30.70）×109/L] was significantly related negatively to the blood levels of TNF-a [（39.93±18.88）ng/ml], LPS [（439.38±91A8）IU/L], IL-6[（417.61±73.66） ng/ml] and PAF[（16359.91±4321.92）ng/L] （P〈0.01） and the blood levels of D-D[（1934.92±708.49）U/L] and APTT[（69.44±15.52）s] were significantly related positively to the blood levels of TNF-a, LPS, IL-6 and PAF in the patients with TBI （P〈0.01）. The blood levels of D-D, APTT, TNF-a, LPS, IL-6 and PAT were significantly higher in the patients with TBI than those in the control group （P〈0.01）. The blood level of PLT was significantly lower in the patients with TBI than that in the control group （P〈0.01）. Conclusions It is suggested that TNF-a, LPS, IL-6 and PAF may participate in the pathogenesis of the blood coagulation function disorder in the patients with TBI. The treatment early after TBI directed at the changes in the blood levels of TNF-a, LPS, IL-6 anti PAF may be helpful to improve the coagulation function and the decrease in the mortality in the patients with TBL.
出处
《中国临床神经外科杂志》
2015年第1期25-27,共3页
Chinese Journal of Clinical Neurosurgery
关键词
颅脑损伤
凝血功能
肿瘤坏死因子-α
内毒素
白细胞介素-6
血小板活化因子
Traumatic brain injury
Acute coagulating dysfunction
Tumor necrosis factor-a
Lipopolysaccharide
Interleukin-6
Platelet-activating factor
