严重肺挫伤患者血浆vWF因子的动态变化及其临床意义

Dynamic Changes of Von Willebrand Factor (vWF) in Severe Pulmonary Contusion and Its Clinical Significance

目的通过检测严重肺挫伤患者血中血管性假血友病因子(vWF)在受伤后不同时点的含量,揭示其动态变化规律及对病情变化和预后的影响。方法将63例严重肺挫伤患者根据ALI/ARDS诊断标准分成ALI/ARDS组(A组)和非ALI/ARDS组(B组)两组,并引入对照组(C组),使用ELISA法分别检测伤后24h内、第3天、第5天、第7天时的血浆vWF水平,观察其动态规律,并比较各组的临床结果。结果严重肺挫伤ALI/ARDS组血浆vWF含量呈动态变化,发病后即升高,且各时段逐渐升高;严重肺挫伤非ALI/ARDS组血浆vWF含量亦呈动态变化,发病后先升高后降低;严重肺挫伤ALI/ARDS组后期死亡率明显增加。结论严重肺挫伤血浆vWF含量呈动态变化,动态血浆vWF水平可以作为严重肺挫伤后ARDS的预测及预后指标。

Objective To show its dynamic changes and its influence on the condition and prognosis by detecting the von Willebrand factor （vWF）level in severe pulmonary contusion at different time points after injuries. Methods According to the diagnostic standard of AL- I/ARDS, 63 cases of severe pulmonary contusion were divided into two groups：severe pulmonary contusion with ALI/ARDS （group A ） and severe pulmonary contusion with no AIMARDS（group B ）. And there was a control group（group C ）, and the plasma vWF level was detected by double-antibody sandwich enzyme-linked immunosorbent assay（ELISA ） at days of 1,3,5 and 7, respectively. Its dynamic regularity was observed and the clinical results of each group were compared. Results The plasma vWF level dynamically changed in severe pulmonary contusion with AIMARDS, it rose immediately after injury and rose gradually at all time points. The plasma vWF level also dynamically changed in severe pulmonary contusion with no ALI/ARDS,it rose first after injury and downed later. The mortality rate of later period was markedly in- creased in severe pulmonary contusion with ALI/ARDS. Conclusion The plasma vWF level dynamically changes in severe pulmonary contusion and its level may be as an indicator for prediction and prognosis of ALI/ARDS caused by severe pulmonary contusion.