血清CRP和PA水平变化在颅脑损伤患者中的临床比较

Comparison of changes of serum CRP and PA level in patients with craniocerebral injury

目的:探讨血清C-反应蛋白(CRP)、前白蛋白(PA)浓度的变化在颅脑损伤患者中的临床价值。方法:采用免疫速率散射比浊法检测已根据GCS评分标准分为轻、中、重型三组的颅脑损伤患者的血清CRP和PA水平,分别检测患者伤后第1、3、7、14天上午8时的血清值。结果:中、重型组在伤后当天血清CRP即升高,第3天达到最大值;而轻型组除第3天CRP高于正常值外,其他各天检测值在正常范围。中型与轻型伤后1、3、7、14天血清CRP浓度比较(均P<0.01);重型与轻型比较(均P<0.01);重型与中型比较(均P<0.01)。中型与轻型伤后第1、3、7、14天血清PA浓度比较,损伤第3天,P<0.01;损伤第1、7、14天,PA浓度虽有一定的差异,但差异无统计学意义(P>0.05)。而重型与轻型比较,损伤第3天,均P<0.01;损伤第1、7、14天,PA浓度虽有一定的差异,但差异无统计学意义(P>0.05)。重型与中型比较,PA水平太大差异,无统计学意义。以2周后的GCS评分评价患者的短期恢复情况,恢复良好组和恢复欠佳组之间各天CRP值差异均有统计学意义,而PA值均在正常范围。结论:血清CRP的检测对颅脑损伤患者的损伤程度和预后判断具有较高的灵敏度,比PA浓度的变化更具有指导意义。

Objective To explore the clinical values of changes of serum C-reactive protein（CRP） and prealbumin（PA） concentration in patients with craniocerebral injury.Method The immunity speed scattering turbidimetric method was used to examine the serum CRP and PA level in patients with craniocerebral injury,who were divided into three groups as slight,mild and serious group according to the GCS score standard.The serum levels of CRP and PA were examined at 8：00 am on 1,3,7,14th days after injury.Results The serum CRP levels in serious and mild group increased at the same day after injury,and reached the maximal value on the 3rd day,but that in slight group only elevated on the 3rd day,and within normal range in other times.When the serum CRP level on 1,3,7,14th days in mild group was compared with slight group,respectively,showed significant difference（P0.01）.When serious group compared with slight group,respectively,also showed significant difference（P0.01）.Serious group compared with mild group,respectively,the difference was significant（P0.01）.When the serum PA level on 1,3,7,14th days in mild group was compared with slight group,respectively,only the 3rd day showed significant difference（P0.01）,on 1,7,and 14th days,the PA density had certain difference,but showed no significant difference.Serious group compared with slight group,respectively,only the 3rd day showed significant difference（P0.01）,on 1,7,and 14th days,the PA density had certain difference,but showed no significant difference.Serious group compared with mild group,PA level showed no significant difference.The patients′ short-term recovery status was evaluated by GCS score standard two weeks later,the difference in CRP level between good recovery group and unsatisfactory group had remarkable difference,but PA values both in normal range.Conclusion The blood serum CRP examination has the higher sensitivity in judging the injury degree and prognosis in patients with craniocerebral injury,and has more guiding values than PA concentration changes.