脑外伤患者血浆D-D、CRP和Fb的检测及临床观察

Determination of Plasma D-dimer,C-reactive Protein and Fibrinogen Concentrations in Patients with Traumatic Brain Injury and Their Clinical Observation

目的:揭示脑外伤患者血浆D-二聚体(D-D)、C-反应蛋白(CRP)和纤维蛋白原(Fb)浓度,分析其与预后的相关性。方法:收集脑外伤患者86例及对照组30例,检测血浆D-D、CRP和Fb浓度,统计分析其与预后的相关性。结果:脑外伤患者入院后1个月内死亡20例(23.3%)。脑外伤患者血浆D-D、CRP和Fb浓度较对照组明显升高(P<0.01),非生存患者血浆D-D、CRP和Fb浓度较生存患者明显升高(P<0.01),血浆D-D、CRP和Fb浓度预测脑外伤后1个月内死亡均有较高的灵敏度和特异度(P<0.01)。结论:D-D、CRP和Fb共同参与了脑外伤的病理生理过程,该些标志物适合作为一种常规的甄别方法,临床检测这些指标有助于早期预测脑外伤后1个月内死亡的评估。

Objective This study aimed to determine the levels of plasma D-dimer, C-reactive protein, and fibrinogen in patients with traumatic brain injury and to correlate their levels with disease outcome. Methods 30 healthy controls and 86 patients with trau- matic brain injury were included. Concentrations of the plasma D-dimer, C-reactive protein, and fibrinogen were measured. Their asso- ciations with disease outcome were analyzed statistically. Results 20 （23.3%） patients died in a month after traumatic brain injury. The plasma D-dimer, C-reactive protein, and fibrinogen levels were significantly higher than those in healthy controls （ P 〈 0.01 ）, were particulary higher in the non-survivals than in survivals （P 〈 0.01 ）, and predicted 1-month mortality of patients with the high sensitivity and specificity values （ all P 〈 0.01 ）. Conclusion D-timer, C-reactive protein, and fibrinogen may contribute to the pathophysiologic process of traumatic brain injury. These markers are suitable to be used as a general screening method and their plasma levels can be served as useful clinical markers for evaluating 1-month mortality of patients with traumatic brain jury.