血清α-促黑素细胞刺激素在钝性胸部外伤中的水平变化及其临床意义

Dynamic changes of serum alpha-melanocyte-stimulating hormone (α-MSH) in blunt chest trauma,and its clinical significance

目的研究钝性胸部外伤患者血清中α-促黑细胞刺激素(α-MSH)含量的动态变化及其临床意义。方法选取2014年8月—2016年2月收治入院的钝性胸部外伤患者32例和健康体检者32例,分别采用ELISA方法检测血清中α-MSH和TNF-α在入院时以及入院1 d、4 d、7 d的含量,同时采用免疫比浊法检测血清中CRP的动态变化,结合患者的病情分析,比较钝性胸部外伤患者与健康体检者血清中各指标的表达水平,并用ROC曲线判定各指标在钝性胸部外伤疾病中的敏感性和特异性。结果钝性胸部外伤患者血清中α-MSH水平较对照组明显降低(P<0.05),随着病程的延长表现为先降低后升高。患者血清中TNF-α和CRP的水平与α-MSH具有相同的统计学意义,随着病程的延长表现为先升高后降低,在患者入院1 d时达到峰值。ROC曲线分析在钝性胸部外伤患者中,血清中α-MSH,TNF-α和CRP的ROC曲线下面积分别是0.845、0.728、0.637。结论血清中α-MSH的水平在钝性胸部外伤患者中明显降低,并且敏感度及特异性均较TNF和CRP高,在疾病的诊断评估中更具临床意义。

Objective To study the dynamic changes of α-MSH in serum of patients with blunt chest trauma,and its clinical significance. Methods Thirty-two patients with blunt thoracic trauma and 32 healthy subjects（as controls） were enrolled in author＇s hospital from August 2014 to February 2016. The levels of α-MSH and TNF-α in serum were measured by ELISA ld after admission,4d and 7d. The dynamic changes of serum CRP were measured by immunoturbidimetric assay. The serum levels of these markers were compared between the blunt chest trauma patients and the healthy subjects. The ROC curves were used to determine the levels of serum CRP. Index in the blunt chest trauma disease sensitivity and specificity. Results The level of serum α-MSH in patients with blunt chest trauma was significantly lower than that in control group（P〈0.05）,and decreased with the course of disease. Serum levels of TNF-α and CRP in patients with α-MSH had the same statistical significance, with the duration of the performance of at first increased and then decreased in patients with ld peak. The area under ROC curve of serum α-MSH,TNF-α and CRP in patients with blunt thoracic trauma were 0.845,0.728,0.637. Conclusions Serum levels of α-MSH are significantly lower in patients with blunt chest trauma,and the sensitivity and specificity are higher than that of TNF and CRP,thus which are more significant in the diagnosis and evaluation of disease.