多发伤病人血清新喋呤检测的研究

A study on the detection of serum neopterin in patients with multiple traumas

目的 :研究多发伤病人血清新喋呤的变化 ,并探讨其与创伤严重度、感染及脏器功能不全的关系。方法 :测定 2 8例多发伤病人伤后第 1天、第 3天、第 8天血清新喋呤水平 ,同时评定ISS值、APACHEⅡ评分及记录血常规、感染、脏器功能不全情况。结果 :多发伤病人血清新喋呤为 8 81± 7 5 6ng/ml,显著高于对照组的 1 37± 0 75ng/ml (P <0 0 1) ;新喋呤水平与APACHEⅡ评分值正相关 (r =0 5 8,P =0 0 2 ) ;发生脏器功能不全组新喋呤及APACHEⅡ值高于脏器功能正常组 ;发生感染后血清新喋呤从 5 0 5± 4 13ng/ml升至 11 0 3± 10 42ng/ml (P <0 0 5 )。结论 :创伤可引起血清新喋呤水平的升高 ,且与创伤严重度正相关 ;监测血清新喋呤水平变化有助于及早发现感染 。

Aim:To study the change of serum neopterin in patients with multiple traumas and determine its relationship to the severity of trauma、infection and organ dysfunction.Methods:The levels of serum neopterin were detected in 28 cases,1st、3rd、8th days after trauma respectively.The values of ISS,APACHEⅡ and blood routine were determined.Meanwhile,we recorded the occurence of infection and organ dysfunction.Results:The level of serum neopterin in patients with multiple traumas was 8 81±7 56ng/ml,much higher than that of normal controls(1 37±0 75ng/ml),so did in those with infection and organ dysfunction.Neopterin and APACHEⅡ values were positively correlated (r=0 58,P=0 02).Conclusion:Serum neopterin increases in patients with trauma and have a positive correlation to the serverity of trauma.Dynamic detection of neopterin is helpful to discover clinical infection earlier.Neopterin can be used as a parameter warning the occurence of MODS.