急诊创伤患者血清中皮质醇、一氧化氮水平与患者病情严重程度和临床预后的关系分析

Analysis of the relationship between cortisol and nitric oxide levels in serum and severity of disease and clinical prognosis in patients with acute trauma

目的探讨急诊创伤患者血清中皮质醇、NO水平与患者病情严重程度和临床预后的关系。方法收集2015年9月-2016年9月本院收治的150例急诊创伤患者作为研究对象,检测患者血清中皮质醇、NO水平,并采用创伤病情严重程度评分评价患者病情,用相关性分析探讨血清中皮质醇、NO与患者病情评分的关系,用Logistic回归分析探讨急诊创伤患者预后不良的风险因素。结果共24例患者为预后不良,预后不良组患者血清NO、皮质醇、APACHEⅡ评分、ISS评分高于预后良好患者,差异均有统计学意义(P<0.05)。Pearson相关性分析显示,血清中皮质醇和NO与APACHEⅡ评分和ISS评分均呈正相关。Logistic回归分析结果提示,ISS评分(P<0.05)、APACHEⅡ评分(P<0.05)、皮质醇(P<0.05)、NO(P<0.05)评分是患者死亡的独立风险因素。结论急诊创伤患者皮质醇、NO水平与患者病情严重程度和临床预后密切相关。

Objective To study the relationship between cortisol and nitric oxide（ NO） levels in serum and severity of disease and prognosis in patients with acute trauma. Methods 150 trauma patients in our hospital from September 2015 to Septemberas2016 were selected as research objects; cortisol and NO levels in serum of patients were measured and the severity of the disease was evaluated by the severity score of the trauma. The correlation between serum cortisol and NO and the patient＇s score was analyzed by correlation analysis. Logistic regression analysis was used to investigate the risk factors of adverse prognosis in patients with emergency trauma. Results In this study,a total of 24 patients were poor prognosis. The serum NO,cortisol,APACHE II score and ISS score in the patients with poor prognosis were significantly higher than those in the good prognosis patients,and there were statistical significance on the differences（ P〈 0. 05）; Pearson correlation analysis showed that the relationship between results of serum cortisol and NO and APACHEⅡscores and ISS scores were positively correlated. The results of Logistic regression analysis indicated that ISS score（ P〈 0. 05） and APACHE II score（ P〈 0. 05） and cortisol（ P〈 0. 05）,NO（ P〈 0. 05） were independent risk factors for death in patients. Conclusion The levels of cortisol and NO in patients with acute trauma were closely related to the severity and prognosis of the patients.