摘要
目的研究心肌酶谱及凝血功能水平变化与创伤严重程度的相关性。方法选取甘肃省第三人民医院2017年12月-2018年12月收治的多发伤患者82例作为研究组,根据创伤危重评分(ISS)标准将其分为轻度创伤组(27例)、中度创伤组(29例)、重度创伤组(26例),同时选取健康体检志愿者28例作为对照组。测定研究组入院24小时内的心肌酶谱[肌酸激酶(CK)、肌酸激酶MB同工酶(CK-MB)和乳酸脱氢酶(LDH)]水平;凝血功能[活化部分凝血活酶时间(APTT)、D-二聚体(D-D)和血小板(PLT)]水平;测定各组入院后的肝功能[总胆红素(TBil)]、肾功能[血肌酐(Scr)和血尿素氮(BUN))],比较各组死亡率。结果研究组的CK、CK-MB、LDH、APTT、D-D、TBil、Scr和BUN水平明显高于对照组(P<0.05),且与创伤严重程度呈明显正相关(P<0.05);而研究组的PLT水平低于对照组(P<0.05),且与创伤严重程度呈负相关(P<0.05);重度创伤组的死亡率明显高于轻中度创伤组(P<0.05)。结论心肌酶谱及凝血功能水平变化能很好的反映创伤严重程度,对指导临床治疗有一定参考价值。
OBJECTIVE To study the correlation of changes in myocardial enzymes and coagulation function level with trauma severity.METHODS A total of 82 patients with multiple traumas from who were admitted to the hospital December 2017 to December 2018 were enrolled as study group. According to injury severity scoring(ISS)criteria,the study group were divided into mild trauma group(27 cases),moderate trauma group(29 cases)and severe trauma group(26 cases). The 28 healthy volunteers undergoing physical examination were enrolled as control group. The levels of myocardial enzymes [creatine kinase(CK),creatine kinase MB(CK-MB),lactate dehydrogenase(LDH)] within 24 h after admission and coagulation function levels [activated partial thromboplastin time(APTT),D-dimer(DD)and platelet(PLT)] in study group were measured. The liver function [total bilirubin(TBil)] and renal function [serum creatinine(Scr),blood urea nitrogen(BUN)] after admission in each group were measured. The mortality was compared among all groups. RESULTS The levels of CK,CK-MB,LDH,APTT,D-D,TBil,Scr and BUN in study group were significantly higher than the control group(P<0.05). These indexes were significantly positively correlated with trauma severity(P<0.05). PLT level of study group was lower than control group(P<0.05),negatively correlated with trauma severity(P<0.05). The mortality of severe trauma group was significantly higher than mild trauma group and moderate trauma group(P<0.05). CONCLUSION The levels changes of myocardial enzymes and coagulation function could well reflect trauma severity. There was certain reference value for guiding clinical treatment.
作者
冯玉平
FENG Yu-ping(The Third People’s Hospital of Gansu,Lanzhou,730030,China)
出处
《中国初级卫生保健》
2019年第7期98-100,共3页
Chinese Primary Health Care
关键词
心肌酶
凝血功能
创伤严重程度
相关性分析
myocardial enzyme
coagulation function
trauma severity
correlation analysis
