血清肌红蛋白、肌酸激酶与降钙素原检测联合创伤严重度评分评估多发伤患者预后

Value of serum myoglobin, creatine kinase and procalcitonin detection combined with injury severity scores in assessment on prognosis of patients with multiple trauma

目的探讨血清肌红蛋白、肌酸激酶与降钙素原联合创伤严重度评分（ISS）对多发伤患者预后的评估价值。方法回顾性分析40例多发伤患者的临床资料，按患者的ISS分值，分为重伤组（ISS≥16分，14例）和轻伤组（ISS〈16分，26例），分别检测治疗前血清肌红蛋白、肌酸激酶以及降钙素原水平，并与伤后24h急性生理学和慢性健康状况Ⅱ（APACHEⅡ）评分做相关性分析。结果重伤组患者血清肌红蛋白、肌酸激酶及降钙素原水平均高于轻伤组，差异有统计学意义（P〈0．05）；重伤组患者APACHEⅡ评分高于轻伤组，差异有统计学意义（P〈0．05）。结论早期检测血清肌红蛋白、肌酸激酶与降钙素原水平，并联合创伤严重度评分，可以较好地判断多发伤患者预后，值得在临床广泛应用。

Objective To evaluate the assessment value of serum myoglobin, creatine kinase and procalcitonin combined with injury severity scores （ISS） in prognosis of patients with multiple trauma. Methods Clinical date of 40 cases with multiple trauma were retrospectively analyzed, and the patients were divided into severe injury group （ISS ≥ 16 points, 14 cases） and slight injury group （ISS 〈 16 points, 26 cases） according to ISS; serum myoglobin, creatine kinase and procalcitonin levels were detected before operation, acute physiology and chronic health evaluation- Ⅱ （APACHE Ⅱ ） score was evaluated at 24 h after injury. Results The levels of serum myoglobin, creatine kinase and procalcitonin in server injury group were higher than those in slight injury group, the differences were significant （P 〈 0. 05）; and APACHE Ⅱ score in sever injury group was higher than that in slight injury group, the difference was significant （P 〈 0. 05 ）. Conclusions Early detection of serum myoglobin, creatine kinase and procalcitonin level combined with trauma severity score can be better to judge the prognosis of patients with multiple trauma, which is worthy of clinical application.