重型颅脑损伤患者超敏肌钙蛋白I临床意义探讨

Investigation of clinical significance by high-sensitivity cardiac troponin I in severe craniocerebral injury patients

目的探讨重型颅脑损伤患者入院后24 h内超敏肌钙蛋白I(hs-c Tn I)检测值的临床意义。方法 94例重型颅脑损伤患者,均进行hs-c Tn I检测,分析hs-c Tn I与格拉斯哥昏迷评分(GCS评分)、死亡率的关系。结果将94例重型颅脑损伤患者分为特重型组(GCS 3~5分)和重型组(GCS 6~8分)。特重型组64例,hs-c Tn I升高者43例(67.2%),其中hs-c Tn I值明显升高(hs-c Tn I>0.330 ng/ml)者23例(35.9%);重型组30例,hs-c Tn I升高者15例(50.0%),其中hs-c Tn I值明显升高者4例(13.3%)。特重型组患者hs-c Tn I值明显升高所占比例明显高于重型组,差异具有统计学意义(P<0.05)。hs-c Tn I 0.033~0.330 ng/ml、>0.330 ng/ml患者死亡率高于hs-c Tn I<0.033 ng/ml的患者,差异有统计学意义(P<0.05);hs-c Tn I升高程度越高,死亡率越高。结论重型颅脑损伤患者颅脑损伤程度越重,hs-c Tn I异常升高程度越高,更容易出现心血管事件和死亡,hs-c Tn I可作为损伤严重度分级及死亡的预判指标。

Objective To investigate clinical significance by high-sensitivity cardiac troponin I(hs-cTnI)detection value in24h after admission in severe craniocerebral injury patients.Methods A total of94patients with severe craniocerebral injury received hs-cTnI detection.Analysis was made on relationship between hs-cTnI and Glasgow coma scale score(GCS score)and mortality.Results The94patients with severe craniocerebral injury were divided into extra-severe group(3~5GCS points)and severe group(6~8GCS points).Among64patients in the extra-severe group,there were43cases with elevated hs-cTnI(67.2%),with obvious elevation(hscTnI>0.330ng/ml)in23cases(35.9%).Among30patients in the severe group,there were15cases with elevated hs-cTnI(50.0%),with obvious elevation in4cases(13.3%).The extra-severe group had obviously higher proportion of obvious elevation in hs-cTnI than the severe group,and the difference had statistical significance(P<0.05).Patients with hs-cTnI as0.033~0.330ng/ml and>0.330ng/ml had higher mortality than patients with hs-cTnI<0.033ng/ml,and the difference had statistical significance(P<0.05).High elevation degree of hs-cTnI led to igh mortality.Conclusion High severity of severe craniocerebral injury in patients leads to high abnormality degree of hs-cTnI,along with frequent occurrence of cardiovascular events and death.Therefore hs-cTnI can act as the prognosis index for injury severity degree and death.