血浆D-二聚体、CRP及血乳酸在急诊创伤性休克患者中的表达及临床意义

Expression and Clinical Significance of Plasma D-Two Dimer, CRP and Blood Lactate in Patients with Acute Traumatic Shock

目的:探讨血浆D-二聚体、C反应蛋白(CRP)及血乳酸在急诊创伤性休克患者中的表达及临床意义。方法:选取2015年2月到2017年9月期间在我院接受治疗的创伤性休克患者186例,根据患者的最终结局分为存活组和死亡组,其中在病情平稳后转出重症监护室的作为存活组(106例),死亡的患者作为死亡组(80例)。比较两组患者的急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分,并比较两组患者在入院时、入院后12h、入院后24h的血浆D-二聚体、C反应蛋白(CRP)及血乳酸水平,分析血浆D-二聚体、CRP及血乳酸水平与APACHEⅡ评分的相关性。结果:死亡组的APACHEⅡ评分显著高于存活组,差异具有统计学意义(P<0.05);两组的D-二聚体、CRP水平均随着时间的推移逐渐升高,血乳酸水平逐渐降低,差异具有统计学意义(P<0.05);存活组患者的D-二聚体、CRP、血乳酸水平在各个时间点均低于死亡组,差异具有统计学意义(P<0.05)。急诊创伤性休克患者血浆D-二聚体、CRP及血乳酸水平与APACHEⅡ评分均呈正相关(r=0.564、0.676、0.506,P<0.05)。结论:血浆D-二聚体、CRP及血乳酸水平与急诊创伤性休克患者的APACHEⅡ评分存在相关性,临床上可对其进行检测来评估患者的病情和预后情况。

Objective： To investigate the expression and clinical significance of plasma D-two dimer, C reactive protein（CRP） and blood lactate in patients with acute traumatic shock. Methods： 186 patients with traumatic shock who were treated in our hospital from February 2015 to September 2017, and they were divided into survival group and death group according to the final outcome of patients.The patients were transferred out of intensive care unit after the stable condition as the survival group（106 cases）, and the patients were dead as the death group（80 cases）. The scores of acute physiology and chronic health score II（APACHE II） were compared between the two groups, the levels of plasma D-two dimer, C reactive protein（CRP） and blood lactate were compared between the two groups at admission, 12 h after admission and 24 h after admission, and the correlation between the levels of plasma D-two dimer, CRP and blood lactate and APACHE II score was analyzed. Results： The APACHE II score of death group was significantly higher than that of survival group, the difference was statistically significant（P〈0.05）. The levels of D-two dimer and CRP in the two groups were gradually increased with time, and the level of blood lactate was gradually decreased, the difference was statistically significant（P〈0.05）, and the levels of D-two dimer, CRP and blood lactate in the survival group were lower than those in the death group at each time point, and the difference was statistically significant（P〈0.05）. The levels of plasma D-two dimer, CRP and blood lactate in the two groups were positively correlated with APACHE II score（r=0.564, 0.676, 0.506, P〈0.05）. Conclusion： The levels of plasma D-two dimer, CRP and blood lactate are correlated with APACHE II score in patients with acute traumatic shock,which can be assessed clinically to assess the patient＇s condition and prognosis.