急性颅脑损伤患者C-反应蛋白、血小板的动态变化及临床意义

The Dynamic change and clinical significance of C-reactive protein and platelet in patients with acute brain injury

目的探讨急性颅脑损伤患者C-反应蛋白（CRP）、血小板（PLT）的动态变化及其临床意义。方法收集本院2014年至2015年急性颅脑损伤患者120例,根据是否进行手术治疗分成：手术组64例,非手术组56例。根据格拉斯哥预后评分（glasgow outcome score,GOS）分成预后不良组61例（GOS 1-3分）,预后良好组59例（GOS 4-5分）。另选择同期健康体检者50例为对照组。分别于患者伤后1d、3d、7d动态检测CRP、PLT水平变化。结果手术组和非手术组患者伤后1d血清CRP水平均明显升高,之后均逐渐下降,两组均呈下降趋势,但手术组患者下降缓慢,一直维持较高水平,14d时仍显著高于对照组（P〈0.05）。非手术组患者下降显著,下降程度明显高于手术组（P〈0.05）。手术组和非手术组患者伤后1d时PLT均未见升高,术后3d开始逐渐升高,7d时升高显著,手术组患者PLT水平升高程度明显高于非手术组（P〈0.05）。预后不良组和预后良好组血清CRP入院时均升高,术后1d达高峰,之后两组均逐渐下降,预后良好组下降明显,而预后不良组CRP水平下降不明显,持续高水平状态时间长,术后7d时仍显著高于正常水平（P〈0.05）。在各时间点预后不良组血清CRP水平均明显高于预后良好组（P〈0.05）。预后不良组和预后良好组术后1d时PLT水平均变化不大,术后3d均开始逐渐升高,预后不良组患者术后7d PLT水平显著高于预后良好组（P〈0.05）。结论急性颅脑损伤患者血清CRP、PLT的动态变化均存在一定规律,是判断脑损伤急性期病情变化及预后的参考指标。

Objective To investigate C-reactive protein in patients with acute brain injury（CRP）,platelet（PLT）dynamic changes and clinical significance.Methods A hospital in 2014-2015 120 cases of acute brain injury,depending on whether surgery divided into：64cases of surgical group,56 cases of non-surgical group.According to Glasgow Outcome Scale（Glasgow Outcome Score,GOS）divided into 61 cases of poor prognosis group（GOS 1-3scores）,59 patients with good prognosis（GOS 4-5scores）.Another choice the same period 50 cases of healthy control group.After the patients were injured 1d,3d,7ddynamic testing CRP,PLT levels.Results The surgical group and the non-surgical group patients after injury 1dserum CRP levels were significantly increased,decreased gradually after all,the two groups showed a downward trend,but the surgery group were decreased slowly,always maintain a high level,still significantly at 14 dthe control group（P〈0.05）.Patients with non-surgical group decreased significantly,significantly higher than the decline in the extent of the surgery group（P〈0.05）.Surgical and non-surgical group patients after injury when PLT 1dshowed no increased after 3dbegan to rise,increased significantly when 7d,PLT levels were elevated degree of surgical group was significantly higher than the non-surgical group（P〈0.05）.Good prognosis group and a poor prognosis group,serum CRP on admission were increased,and reached a peak after 1d,after declining in both groups,with good prognosis group decreased significantly,while the poor prognosis group,no significant decline in CRP levels,continued high levels of state for a long time When postoperative 7dstill significantly higher than the normal level（P〈0.05）.At each time point the poor prognosis group,serum CRP levels were significantly higher than the good prognosis group（P〈0.05）.When the good prognosis group and a poor prognosis group was mean change 1dPLT little water,began to increase after the 3dwere poor prognosis group of patients was significantly higher than 7dPLT good prognosis group（P〈0.05）.Conclusion Patients with acute brain injury CRP,PLT dynamic changes are certain rules,is to determine the acute phase of the disease of brain injury and prognosis of change.