创伤患者血清载脂蛋白A-1水平与创伤严重程度的关系

Relationship between serum apolipoprotein A-1 level and severity of trauma in patients with trauma

目的探讨创伤患者血清载脂蛋白A-1(apolipoprotein A-1, apoA-1)水平与创伤严重程度的关系。方法回顾性收集上海交通大学附属第六人民医院急性创伤急救中心EICU 2017年10月至2018年4月收治的符合纳入标准的138例创伤患者资料,记录性别、年龄、入院时间、创伤机制、创伤严重度评分(ISS),患者伤后24 h内测定apoA-1水平,根据ISS评分将患者分为三组,即轻伤组(47例,ISS<16)、重伤组(45例,16≤ISS<25)、危重伤组(46例,ISS≥25),采用Pearson相关分析验证apoA-1水平与ISS评分之间的相关性,采用单因素方差分析各创伤组的血清apoA-1水平差异,组间两两比较采用LSD法。结果apoA-1水平与创伤严重程度评分(ISS)呈负相关(r=-0.307;P<0.01),不同创伤组间的apoA-1水平差异有统计学意义(F=8.864,P<0.01),其中以轻伤组与危重伤组间的差异最大(P<0.01),危重伤组的apoA-1水平低于轻伤组(P<0.01)和重伤组(P= 0.038),重伤组apoA-1低于轻伤组(P=0.040)。结论创伤患者早期apoA-1水平与创伤严重程度相关,可能是预测创伤患者预后的较佳指标。

Objective To explore the relationship between serum apolipoprotein A-1 (apoA-1) level and severity of trauma in patients with trauma. Methods Data of 138 trauma patients admitted by EICU from October 2017 to April 2018 in the Acute Trauma Emergency Center of the Sixth People's Hospital Affiliated to Shanghai Jiaotong University were collected retrospectively. Gender, age, admission time, trauma mechanism, and injury severity score (ISS) were recorded, and serum apoA-1 level was measured and recorded within 24 h after injury. Patients were divided into three groups according to the ISS score: the light injury group (47 cases, ISS < 16), the serious injury group (45 cases, 16 ≤ISS < 25), and the critical injury group (46 cases, ISS ≥ 25). The correlation between serum apoA-1 level and ISS score was verified by adopting Pearson correlation analyses, and the differences in serum lipoprotein A level within 24 h after injury were compared among 3 groups by one-way ANOVA. Results Serum apoA-1 level was negatively correlated with ISS score (r=-0.307, P<0.01). There was significant difference in serum apoA-1 level between different trauma groups (F=8.864, P<0.01), among which the difference between the light injury group and critical injury group was the largest (P<0.01). The level of serum apoA-1 in the critical injury group was lower than that in the light injury group (P<0.01) and the serious injury group (P=0.038), while the level of serum apoA-1 in the serious injury group was lower than that in the light injury group (P=0.040). Conclusions Early serum apoA-1 level in patients with trauma is closely related to the severity of trauma and may be a better indicator to evaluate the prognosis of patients with trauma.