炎性因子对多发伤患者预后评估的作用

Prognostic value of wound inflammation factors in patients with multiple traumas

目的探讨创伤炎性因子对多发伤患者预后的评估作用。方法对我院2009-02至2014-03收治的114例多发伤患者,伤后1、2、4、6和12 d血清降钙素(PCT)、血清IL-6与TNF-α含量水平的变化进行检测,纳入患者根据国际AIS-ISS评分标准[3]进行创伤评分。依据ISS评分,ISS<16分者列入轻伤组(n=49);ISS≥16分者列入严重伤组(n=65)。比较两组炎性因子水平变化。结果两组患者血清PCT、IL-6与TNF-α值分别于受伤当日、2 d及4 d达到高峰,之后随着病情缓解逐渐下降。轻伤组各时间段的血清中PCT、IL-6和TNF-α水平明显低于同时间段重伤组,差异具有统计学意义(P<0.05)。结论多发伤患者体内PCT、IL-6与TNF-α等炎性因子含量的变化,能较好地反映病情的发展。对相关炎性因子进行检测可有效评估患者预后,具有较高的临床价值。

Objective To observe the prognostic value of wound inflammation factors in patients with multiple trauma.Methods One hundred and fourteen patients diagnosed with multiple traumas between February 2009 and March 2014 were enrolled in this study. Serum PCT,IL-6 and TNF-α levels were analyzed 1,2,4,6,and 12 days after injury. According to the ISS score,patients with an ISS 16 points were included in the minor injury group（ n = 49） while those with an ISS ≥16 points were included in the severe injury group（ n = 65）. The changes of inflammatory response factors were compared between the two groups. Results The serum PCT,IL-6 and TNF-α levels reached their peaks at the first day,second day and fourth day after injury respectively. The serum PCT,IL-6 and TNF alpha levels were lower in minor trauma group than in serious trauma group（ P〈0. 05）. Conclusions The changes in serum PCT,IL-6,TNF-α levels after injury could serve as ideal markers for prognosis prediction and are of high clinical value.