交通伤患者血清肌酸激酶动态变化对病情及预后的评估价值

Evaluation Value of the Dynamic Changes of Serum Creatine Kinase in Traffic Injury Patients on Injury Condition and Prognosis

目的探讨交通伤患者血清肌酸激酶(CK)动态变化对病情严重程度及预后的评估价值。方法选取2012年6月—2013年7月于新疆医科大学第一附属医院治疗的交通伤患者61例为研究对象。根据患者是否发生院内死亡,分为死亡组(16例)和存活组(45例);另根据患者损伤严重度评分(ISS),分为重伤组(ISS≥25分,38例)和轻伤组(ISS<25分,23例)。结果患者交通伤后第1、2、5天血清CK水平分别为1 360(261)、1 520(172)、540(496)U/L,患者不同时间CK水平比较,差异有统计学意义(H=36.029,P<0.05),其中第2天CK水平高于第1、5天,差异有统计学意义(H=59.314、51.209,P<0.018)。死亡组第1天CK水平低于存活组,第2、5天CK水平高于存活组,差异有统计学意义(P<0.05)。死亡组患者第1、2、5天血清CK水平比较,差异有统计学意义(H=9.414,P<0.05),其中,第2、5天血清CK水平高于第1天,差异有统计学意义(H=18.146、23.186,P<0.018)。重伤组第1、2、5天血清CK水平均高于轻伤组,差异有统计学意义(H=11.235、15.556、22.705,P<0.05)。结论血清CK水平的动态变化与患者受伤严重程度有关,可作为评估交通伤患者病情严重程度和预后的临床检测指标。

Objective To study the evaluation value of dynamic changes of the serum creatine kinase（ CK）in traffic injury patients on injury condition and prognosis. Methods We enrolled 61 traffic injury patients who were admitted into the First Affiliated Hospital of Xinjiang medical University from June 2012 to July 2013. The subjects were divided into death group （n=16）and survival group（n=45）according to death or survival and were also divided into severe injury group（n=38,ISS≥25）and slight injury group（n=23,ISS〈25）according to ISS score. Results The level of serum CK of the subjects on day 1,day 2 and day 5 were 1 360（261）,1 520（172）and 540（496）U/L. The subjects had significant different CK levels（H=36. 029,P〈0. 05）at different time points,with the CK level of day 2 higher than that on day 1 and day 5（H=59. 314,51. 209;P〈0. 018）. The death group was lower（P〈0. 05）than the survival group in CK level on day 1 and were higher（P〈0. 05）than the survival group in CK level on day 2 and day 5. The death group had significantly different CK levels （H=9. 414,P〈0. 05）on day 1,day 2 and day 5,with the serum CK levels on day 2 and day 5 higher than that on day 1（H=18. 146,23. 186;P〈0. 018）. The severe injury group was higher than the slight injury group in serum CK level on day 1, day 2 and day 5 （ H =11. 235,15. 556,22. 705;P 〈0. 05 ）. Conclusion The dynamic changes of serum CK level are related with the severity degree of traffic injury patients and can be used as the clinical indicators of injury severity and prognosis of traffic injury patients.