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创伤后瘦素及其受体的变化及临床意义研究 被引量:3

Dynamic fluctuation of leptin and ob-R levels of patients with trauma injury and the clinical significance
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摘要 目的观察创伤后瘦素(leptin)及其受体(ob-R)的变化,初步探讨二者在创伤恢复过程中的临床意义。方法2007年7月-2008年3月收治的52位创伤患者依据AIS-ISS评分分为3组:①轻伤组(ISS<16或AIS≤2,n=21);②重伤组(16≤ISS<25或AIS=3,n=17);③严重伤组(ISS≥25或AIS>3,n=14)。以1个月来无感染病史的7位健康人作为对照。采集患者入院第1天(D1)、第3天(D2)、第6天(D3)以及对照组成员(D0)血清,酶联免疫吸附法(ELISA)测定血清瘦素及ob-R水平。结果严重伤组SIRS、MODS、脓毒症发生率均高于重伤组及轻伤组(P<0.05)。随创伤程度的加重,各时相点瘦素与ob-R水平也随之增高。D1时,重伤组、轻伤组、对照组间瘦素水平无显著差异(P>0.05),但3组均显著低于严重伤组(P<0.05)。D2时,重伤组和轻伤组瘦素水平均显著高于对照组(P<0.05),且3组均显著低于严重伤组(P<0.05)。D3时各组间比较结果与D1相同。ob-R水平D1、D2、D3时4组间比较均有显著性差异(P<0.05)。结论创伤后瘦素及ob-R水平均随创伤程度的加重而增加,测定创伤后瘦素水平的变化在一定程度上可判断创伤程度及预后。与瘦素相比,ob-R的变化持续时间更长,对损伤更为敏感。 Objective To observe the dynamic changes of leptin and leptin receptor (ob-R) levels in serum of patients with trauma injury, and study the clinical significance during the restoration process. Methods The data, including general condition and prognosis, of 52 patients with trauma injury, who were admitted from July 2007 to March 2008, were retrospectively analyzed. The patients were divided into three groups according to the AIS-ISS scores: mild injury group (ISS〈S16 or AIS≤2, n=21), moderate injury group (16≤ISS〈25 or AIS=3, n=17) and severe injury group (ISS≥25 or AIS〉3, n=14). Seven healthy persons without infection in one month were served as controls. Serum samples were collected from both the patients and controls at the admission day (D1), and the third day (D2) and sixth day (D3) after admission. ELISA was used to determine the levels of leptin and ob-R in serum. Results The incidence of complications including SIRS, MODS and SEPSIS increased in severe injury group compared with that in the other two groups (P〈0.05). The leptin and ob-R levels increased following the aggravation of trauma at every time point. At D1 time point, no significant difference existed in leptin level (P〉0.05) compared between the control group and mild and moderate injury groups, and between the mild and moderate injury group (P〉0.05), while the leptin level in serious injury group was higher than in all the other groups (P〈0.05). At D2 time point, the leptin level increased significantly in moderate group compared with that in mild group and control group, and in severe group compared with that of the other groups (P〈0.05). The situation of leptin levels at D3 point was similar to that at D1 point. As far as ob-R was concerned, the significant differences occurred among all these groups (P〈0.05) at every time point. Conclusions Serum levels of leptin and ob-R in trauma patients may increase significantly following the aggravation of trauma. The changes of leptin and ob-R after trauma may be helpful to judge the extent and prognosis of trauma. Compared with leptin, the dynamic changes of ob-R level is more sensitive, and lasts longer.
出处 《解放军医学杂志》 CAS CSCD 北大核心 2008年第12期1410-1412,共3页 Medical Journal of Chinese People's Liberation Army
关键词 瘦素 受体 瘦素 创伤和损伤 leptin receptors, leptin wounds and injuries
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