颅脑损伤急性期血小板参数与外伤性脑梗死的关系

Relationship between Platelet Parameters and Traumatic Cerebral Infarction in Acute Phase of Craniocerebral Injury

目的探讨颅脑损伤急性期血小板(PLT)参数与外伤性脑梗死(TCI)的关系。方法选取2010年9月-2012年1月符合纳入除标准的颅脑损伤患者191例。将伤后14 d内发生脑梗死的患者划入观察组,余为对照组。分别于伤后第24、48小时,第3、7、14天,采集肘静脉血对PLT计数、PLT平均体积(MPV)、PLT体积分布宽度(PDW);伤后24 h行格拉斯哥昏迷评分(GCS),伤后6个月随访行格拉斯哥结果评分(GOS)。分别分析脑梗死与上述PLT参数的关系、PLT参数与颅脑损伤病情轻重的关系以及与预后的关系。结果观察组PLT计数降低、MPV升高、PDW升高;观察组患者GCS/GOS与PLT计数呈正相关,与MPV、PDW呈负相关。结论 PLT计数、MPV、PDW均与TCI有关,三者中PLT最具临床意义。PLT计数越低、MPV和PDW越高,脑梗死可能性越大,颅脑损伤可能越严重,预后可能越差。

Objective To investigate the relationship between platelet parameters and traumatic cerebral infarction in the acute phase of craniocerebral injury.Methods A total of 191 traumatic patients treated in our hospital from September 2010 to January 2012 were included in our study.Patients with the occurrence of cerebral infarction within 14 days of injury were designated into the experimental group,and the rest patients formed the control group.The platelet（PLT） count,mean platelet volume（MPV）,and platelet distribution width（PDW） were detected 24,48 hours,and 3,7,14 days after injury.Glasgow Coma Scale（GCS） was used 24 hours after injury and Glasgow Outcome Scale（GOS） was used six months after injury during the follow-up.The relationships between PLT parameters and traumatic cerebral infarction,PLT parameters and the severity of craniocerebral injury,and PLT parameters and prognosis were analyzed respectively.Results In the experimental group,PLT count was decreased,and MPV and PDW were increased.PLT count was positively correlated with GCS/GOS;and MPV/PDW was negatively correlated with GCS/GOS.Conclusions The PLT count,MPV and PDW are related to traumatic cerebral infarction,and PLT count is most significant.The lower PLT count is,or the higher MPV and PDW are,the more likely cerebral infarction occurs,the more serious traumatic brain injury is and the poorer the prognosis seems to be.