严重创伤合并ARDS患者血清C反应蛋白水平的动态观察及意义

Observation on CRP levels in severe trauma patients with ARDS and its significance

目的探讨创伤患者血清C反应蛋白(CRP)的水平与创伤性ARDS之间的关系及其临床意义。方法将52例严重创伤患者(ISS评分≥16分)分为创伤后并发ARDS组13例(ARDS组)与创伤后未并发ARDS组39例(非ARDS组),另10例健康人为正常对照组。半随机对照实验。分别于伤后第1、2、3、7天收集外周血。运用ELISA方法测定外周血血清C反应蛋白(CRP)浓度。结果正常对照组CRP水平在各时相点变化不明显,而非ARDS组CRP水平先升高后降低,ARDS组CRP水平持续升高。与正常对照组相比,非ARDS组血清CRP水平升高了10倍多,而ARDS组的CRP水平升高了30多倍;与非ARDS组相比,ARDS组的CRP水平升高了2倍多。结论创伤后急性期CRP水平的升高程度不仅与创伤严重程度有关,而且与创伤性ARDS的发生密切相关。因此,测定严重多发伤急性期外周血血清CRP浓度对预测创伤性ARDS的发生具有一定价值。

Objective To explore the relation between traumatic ARDS and the level of serum C reactive protein(CRP)in severe trauma patients. Methods Fifty-two severe multiple-injury patients (ISS≥16) were devided into ARDS group(13 cases) and non-ARDS group(39 cases). Another 10 healthy people served as the control group. The semi-random control trial was conducted. Peripheral blood was collected on 1,2,3,7 day after trauma. The CRP concentrations were determined with ELISA. Results The serum CRP level of the control group changed a little during the whole observation,while in the non ARDS group,it elevated first,and then declined,in the traumatic ARDS group,it elevated continuously,compared to the control group,the CRP level of the non-ARDS group increased by more than 10 times,that in the ARDS group was increased more than 30 times. Compared to the non-ARDS group,the serum CRP level of the ARDS group was increased more than 2 times. Conclusion The results suggested that the CRP level is not only relevant to the severity of trauma,but also closely to the occurence of traumatic ARDS after trauma. The observation of peripheral serum CRP concentration can predict the occurrence of ARDS.