芦山与汶川地震中伤员血浆纤维蛋白原水平的研究

Analysis of Fibrinogen Level in Patients Injured in Lushan and Wenchuan Earthquake

目的探讨芦山与汶川地震所致伤员及不同救治时间伤员血浆纤维蛋白原(Fbg)水平的变化。方法选择2013年4月20日-24日入院治疗的276例芦山地震伤员和2008年5月13日-17日入院治疗的503例汶川地震伤员为研究对象,按灾后入院时间分别分为5组,检测患者血浆Fbg水平,分析血浆Fbg水平变化以及不同入院时间的患者血浆Fbg水平变化,分别对芦山地震和汶川地震各组间Fbg水平进行两两比较;将91例芦山地震骨折伤员和130例汶川地震骨折伤员分为肢体多处骨折组和肢体单处骨折组,分层分析两次地震Fbg水平的差异。结果芦山地震伤员的Fbg整体水平[(2.70±1.15)g/L]低于汶川地震伤员[(4.47±1.94)g/L],相同入院时间芦山地震伤员Fbg水平均低于汶川地震伤员,差异有统计学意义(P<0.01);地震后48 h以内入院的伤员Fbg水平与48 h以后入院的伤员Fbg水平差异有统计学意义(P<0.01);芦山地震中肢体多处骨折伤员与肢体单处骨折伤员Fbg水平[分别为(2.21±0.76)、(1.98±0.85)g/L]均低于汶川地震[分别为(3.35±1.48)、(3.11±1.05)g/L],差异有统计学意义(P<0.01)。结论在突发事件等引起的急性应激损伤中患者血浆Fbg水平有不同程度的变化,不同入院时间患者Fbg水平的变化也有所差异,应针对此采取相应防治措施。

Objective To explore fibrinogen（Fbg） variety in the patients wounded in Lushan and Wenchuan earthquake. Methods As the research subjects, 276 Lushan earthquake victims（from April 20 th to 24 th, 2013） and 503 Wenchuan earthquake victims（from May 13 th to 17 th, 2008） were divided into five groups according to the admission date, and then the Fbg variety in those earthquake victims were analyzed. We carried out pairwise comparison among these groups in the Lushan earthquake and Wenchuan earthquake respectively on the Fbg variety. Ninety-one fracture patients in the Lushsan earthquake and 130 fracture patients in the Wenchuan earthquake were divided into two groups according to clinical diagnosis： multiple fracture and single fracture, and then we evaluated the Fbg values in patients with different degrees of disability. Results The whole Fbg level [（2.70±1.15） g/L] in Lushan earthquake was below the level [（4.47±1.94） g/L] in Wenchuan earthquake, and the difference was statistically significant（P〈0.01）. The Fbg level in the patients whose admission date was within 48 hours was significantly different with that in patients whose admission date was more than 48 hours（P〈0.01）. The Fbg level in Lushan earthquake was below the level in Wenchuan earthquake, not only in the multiple fracture group but also in the single fracture group [in Lushan earthquake, the former was（2.21±0.76） g/L, and the latter was（1.98±0.85） g/L; in Wenchuan earthquake, the former was（3.35±1.48） g/L, and the latter was（3.11±1.05） g/L], and the difference was statistically significant（P〈0.01）. Conclusion Blood coagulation, especially Fbg level, has different degrees of changes in acute stress caused by emergency and in different treatment times, and it is better to take preventive measures.