脑外伤后颅内感染患者血液流变学指标的变化观察

Changes of hemorheology indexes of patients with intracranial infections after traumatic brain injury

目的观察脑外伤后患者颅内感染血液流变学指标的变化情况,为脑外伤后颅内感染的治疗提供依据。方法选取2013年7月-2015年8月医院收治的脑外伤后颅内感染患者43例为观察组,并以同时期的脑外伤后未发生颅内感染的患者43例为对照组,然后将两组患者的高切、中切及低切全血黏度、全血还原黏度及其他血流变指标进行比较,并比较轻度、中度及重度颅内感染者的上述检测结果。结果观察组高切、中切及低切全血黏度分别为(5.33±0.45)mPa·s、(6.28±0.62)mPa·s及(12.83±1.37)mPa·s,均高于对照组(4.20±0.33)mPa·s、(5.11±0.50)mPa·s及(8.98±1.13)mPa·s;观察组高切、中切及低切全血还原黏度及血沉方程K值、红细胞聚集指数、血细胞比容(%)为(8.72±0.75)mPa·s、(11.90±1.25)mPa·s、(24.54±2.20)mPa·s、103.63±10.67、16.48±3.23、(45.35±3.78)%,均明显高于对照组(6.16±0.59)mPa·s、(8.86±0.88)mPa·s、(17.67±1.55)mPa·s、88.35±7.27、11.35±2.25、(39.89±3.32)%;同时,中度感染、重度感染患者全血黏度(高切、中切、低切)、全血还原黏度(高切、中切、低切)、血沉方程K值、红细胞聚集指数、血细胞比容(%),均高于轻度感染,且重度感染患者相关指标均高于中度感染,差异均有统计学意义(P<0.05)。结论脑外伤后颅内感染患者血液流变学指标的变化较为明显,且颅内感染严重程度对其检测水平影响较大。

OBJECTIVE To observe the changes of hemorheology indexes of patients with intracranial infections after traumatic brain injury so as to provide guidance for treatment of the intracranial infections after the traumatic brain injury. METHODS From Jul 2013 to Aug 2015, a total of 43 patients who had intracranial infections after the traumatic brain injury were chosen as the observation group, meanwhile, 43 patients who did not have intracranial infections after the traumatic brain injury were set as the control group. The high, medium and low shear whole blood viscosity, whole blood reduced viscosity, and other hemorheology indexes were compared between the two groups of patients and were compared among the patients with mild, moderate and severe intraeranial infections. RESULTS The high shear whole blood viscosity of the observation group was （5.33±0.45）mPa·s, higher than （4. 20±0.33）mPa·sof the control group; the medium shear whole blood viscosity of the observation group was （6.28-±0.62）mPa·s, higher than （5.11±0.50）mPa·s of the control group; the low shear whole blood viscosity of the observation group was （12.83±1.37）mPa·s, higher than （8. 98±1.13）mPa·s of the control group. The high shear whole blood reduced viscosity of the observation group was （8.72±0.75） mPa·s, significantly higher than （6. 16±0.59）mPa·s of the control group; the medium shear whole blood reduced viscosity of the observation group was （11.90±1.25） mPa·s, significantly higher than （8.86±0.88）mPa ·s of the control group; the low shear whole blood reduced viscosity of the observation group was （24.54±2.20）mPa·s, significantly higher than （17.67±1.55）mPa ·s of the control group ; the erythrocyte sedimentation equation K value of the ob servation group was 103.63±10.67, significantly higher than 88.35 ±7.27 of the control group; the erythrocyte aggregation index of the observation group was 16.48±3. 23, significantly higher than 11.35±2. 25 of thecontrol group the haematocrit of the observation group was （45.35±3.78）, significantly higher than （39.89± 3.32） of the control group. The whole blood viscosity （high, medium, and low shear）, whole blood reduced viscosity （high, medium, and low shear）, erythrocyte sedimentation equation K value, erythrocyte aggregation in- dex, and haematocrit （~） of the patients with moderate or severe infection were higher than those with mild infec- tions, and the above indexes of the patients with severe infections were higher than those with moderate infections （P〈0.05）. CONCLUSION The hemorheology indexes of the patients with intracranial infections change remark- ably after the traumatic brain injury, which are influenced by the severity of the intracranial infections.