期刊文献+

骨折后脂肪栓塞综合征患者肌酶肌钙蛋白ID-二聚体肺CT变化 被引量:8

Changes of muscle enzymes, troponin I, D - dimer, lung CT in the patients with fat embolism syndrome after fracture
下载PDF
导出
摘要 目的比较骨折后脂肪栓塞综合征(FES)患者与同期同类型骨折患者(对照组)各时间段肌酶、肌钙蛋白I(Tnl)、D-二聚体(D-dimer)、肺CT的变化,观察各项指标与病情变化之间的联系。方法35例患者根据Gurd提出的诊断标准确诊为FES,其中31例抢救治疗成活,监测发病后≤24h及3、5、7d时肌酶、TnI、血凝分析,与对照组进行对比。检查发病3d内和2周内肺CT。对比各项检查指标变化及其之间的联系。结果与对照组比较,35例FES患者肌酶均升高,31例经抢救治疗成活患者中28例≤24h达高峰,35例TnI、D-dimer、纤维蛋白原(Fib)也均升高;两组患者肌酶、TnI、Fib、D-dimer比较差异有统计学意义。肺CT在急性期呈点片状、絮状、暴风雪样高密度影,随病情好转肌酶、胸部影像、临床症状的好转是同步的。结论骨折后发生FES的患者肌酶、TnI、D-dimer、Fib均比对照组增高,其数值随病情好转下降,与肺部影像吸收好转相一致。测定肌酶、TnI、D-dimer、Fib可为该病诊断、观察治疗效果提供依据。 Objective To explore the changes of muscle enzymes, troponin I ( TnI), D - dimer and lung CT in the patients with fat embolism syndrome (FES) after fracture. Methods Muscle enzyme, TnI, D - dimer and fibrinogen (Fib) were measured at 3,5 and 7 day 'after the onset of FES in 35 patients. Age - matched patients with the same type of fracture were used as control group. All the patients with FES underwent lung CT at 3 days and 2 weeks after the onset of FES. Results Compared with the control group, muscle enzymes were significantly elevated in FES group. In 31 patients who survived, muscle enzyme peaked within 24 h in 28 patients. TnI, D - dimer, Fib were significantly higher in 35 patients than in control group. Lung CT in the acute phase revealed wide spread petechial high- intensity signal. Enzymes decreased and chest imaging changes improved with resolution of clinical symptoms. Conclusion The serum levels of muscle enzymes, TnI, D - dimer and Fib in the patients with FES are higher than those of control group at acute stage and gradually return to normal level as FES improved . Muscle enzymes, TnI and D - dimer might be useful in diagnosing FES and monitoring therapeutic effect.
出处 《中国急救医学》 CAS CSCD 北大核心 2013年第3期220-224,共5页 Chinese Journal of Critical Care Medicine
基金 河北省科技厅支撑计划项目072761499
关键词 脂肪栓塞综合征(FES) 肌酶 肌钙蛋白I(TnI) D-二聚体(D-dimer) 肺CT Fat embolism syndrome(FES) Muscle enzymes Troponin I(TnI) D - dimer Lung computed tomography (CT)
  • 相关文献

参考文献25

  • 1Gurd AR, Wilson RI. The fat embolism syndrome [ J]. J Bone Joint Surg Br, 1974, 56B(3) : 408 -416.
  • 2Mudd KL, Hunt A, Matherly RC, etal. Analysis of pulmonary fat embolism in blunt force fatalities [ J ]. Trauma, 2000, 48 ( 4 ) : 711-715.
  • 3Eriksson EA, Pellegrini DC, Vanderkolk WE, et al. incidence of pulmonary fat embolism at autopsy: an undiagnosed epidemic[ J ]. Trauma, 2011, 71 (2): 312-315.
  • 4Nikoli c: S, Mici c, J, Savi c S, et al. Post - traumatic pulmonary and systemic fat embolism in forensic practice. Prospective histological study [ J ]. Srp Arh Celoklek, 2000, 128 (3 - 4) :90 - 93.
  • 5崔玉鹏,高红,许葆华,周丽丽,杨则宜.补充复方1,6-二磷酸果糖及谷氨酰胺对训练大鼠游泳运动能力和运动后骨骼肌损伤的影响[J].中国运动医学杂志,2006,25(1):26-30. 被引量:7
  • 6周越,李扬,王瑞元,李肃反,龙国东,杨则宜.运动性骨骼肌损伤评价指标--血清CK、LDH、Mb的比较[J].中国运动医学杂志,2008,27(2):206-208. 被引量:42
  • 7Kini AS, Lee P, Marmur JD, et al. Correlation of postpercutane- ous coronary intervention kinase - MB and troponin I elevation in predicting midterm mortality [ J ]. Am J Cardiol, 2004, 93 ( 1 ) : 18 -23.
  • 8冯连世,冯炜权.运动与血清酶活性的变化[J].中国运动医学杂志,1991,10(2):88-94. 被引量:99
  • 9朱宣德,梁桥安,黄永煜,李国洪,汤步阶,刘暖林,李远辉.CK-MB在急性颅脑损伤和自发性脑出血患者的变化规律[J].中华实用诊断与治疗杂志,2008,22(11):865-866. 被引量:6
  • 10Bova C, Crocco F, Ricchio R, et al. Importance of troponin T for the risk stratification of normotensive patients with pulmonary embolism. A prospective, cohort study witll a three - month follow-up[J]. Hematologica, 2005, 90(3): 423-424.

二级参考文献78

共引文献167

同被引文献73

引证文献8

二级引证文献34

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部