急性脑外伤后血清甲状腺激素催乳素皮质醇和C肽的动态观察及其临床意义

Dynamic observation and its clinic significance of serum thyrooxin,prolactin,cortisol and Cpeptide in acute head trauma

为进一步了解脑外伤后体内甲状腺激素、催乳素、皮质醇和Ｃ肽的变化及其临床意义，对５５例急性脑外伤患者血清甲状腺激素、催乳素、皮质醇和Ｃ肽进行了动态观察，并对反映伤情的格拉斯哥昏迷计分（ＧＣＳ）和反映预后的格拉斯哥预后计分（ＧＯＳ）分别进行了多元逐步回归分析。结果：①脑外伤组血清３，５，３′三碘甲状腺原氨酸（Ｔ３）、甲状腺素（Ｔ４）、３，３′，５′Ｌ三碘甲状腺原氨酸（ｒＴ３）较对照组有明显改变，在动态观察中催乳素（ＰＲＬ）、皮质醇（ＣＯＬ）未见有显著改变。②不同伤情的各种激素改变不同，ｒＴ３和Ｃ肽水平与损伤程度呈正相关。③采用多因素分析方法对伤情的估计和对预后的预测进行了初步探讨，并建立了有统计学意义的回归方程。本研究表明，急性脑外伤后血清甲状腺激素和Ｃ肽水平的变化与伤情有密切关系，回归方程的建立。

A dynamic observation on serum thyroxine,prolaction,cortisol and Cpeptide was done in 55 patients with acute head trauma.Also done was a multivariate stepwise regression analysis of GSC and GOS,which reflected the severity of injury and the prognosis respectively.The results showed:(1)3,5,3'triiodothyronine(T 3),thyroxin(T 4),and 3,3',5'triiodothyronine(rT 3) of the patients in head trauma group were found to have remarkable changes as compared with the control group,and no significant changes in prolactin and cortisol were seen during the dynamic observation;(2)changes of different hormons reflected different severity of injury,the levels of rT 3 and Cpeptide(CP) being positively correlated with the degree of injury;(3)with the use of multivariate analysis,the estimation of the severity of injury and the prediction of prognsis were preliminarily discussed,and a regression equation with statistical significance was established.It is suggested that changes of serum thyroxin and CP after acute head trauma are closely related to the severity of injury,and the institution of the regression equation plays a certain role in the emergency treatment and the assessement of prognosis of the patients with acute head trauma.