急性创伤性凝血病患者CRP、APC及D-D水平及意义

Levels and significance of CRP,APC and D-D in patients with acute traumatic coagulopathy

目的探讨急性创伤性凝血病患者C反应蛋白(CRP)、活化蛋白C(APC)及D-二聚体(D-D)水平及意义。方法选取2018年1月一2019年3月在万宁市人民医院治疗的多发伤患者,且并发急性创伤性凝血病患者112例(观察组),同时选取未合并急性创伤性凝血病患者224例作为对照组,检测CRP、APC及D-D水平。结果观察组CRP、APC、D-D及ISS评分分别为(112.20±34.43)mg/L.(3.76±1.00)ng/mL、(198.28±23.20)ng/mL和(25.02±2.22)分,明显高于对照组(P<0.05),而GCS评分为(7.66+1.10)分,明显低于对照组(P<0.05);Logistic回归分析结果显示:CRP、APC、D-D、ISS评分及GCS评分为急性创伤性凝血病发生的影响因素(OR=1.353、1.347.1.365、.1.559和0.804,P<0.05);观察组死亡患者CRP、APC、D-D及ISS评分分别为(125.59±31.29)mg/L.(4.22±1.04)ng/mL、(218.82±20.02)ng/mL和(26.81±2.03)分,明显高于存活患者(P<0.05),而GCS评分为(6.03±1.09)分,明显低于存活患者(P<0.05)。结论急性创伤性凝血病患者CRP、APC及D-D水平升高,与疾病的发生及预后有一定关系,值得进一步研究。

Objective To investigate the levels and significance of C-reactive protein(CRP),activated protein C(APC)and D-dimer(D-D)in patients with acute traumatic coagulopathy.Methods From January 2018 to March 2019,112 patients with muliple trauma and acule traumatic coagulopathy were selected(observation group),224 multiple trauma patients without acute traumatic coagulopathy were selected as control group,the levels of CRP,APC and D-D were measured.Results The CRP,APC,D-D and ISS scores of the observation group were(112.20±34.43)mg/L,(3.76±1.00)ng/mL,(198.28±23.20)ng/mL and(25.02±2.22),which were significantly higher than those of the control group(P<0.05),while the GCS score was(7.66±1.10),which was significantly lower than that of the control group(P<0.05);Lo-gistic regression analysis showed that CRP,APC,D-D,IsS and GCS were the influencing factors of the occurrence of acute traumatic coagulopathy(OR=1.353,1.347,1.365,1.559 and 0.804,P<0.05);The CRP,APC,D-D and ISS scores of the dead patients in the observation group were(125.59±31.29)mg/L(4.22±1.04)ng/mL,(218.82±20.02)ng/mL and(26.81±2.03),which were significantly higher than those of the suvivors(P<0.05),while the GCS scores were(6.03±1.09),which were significanly lower than those of the survivors(P<0.05).Conclusion The elevated levels of CRP,APC and D-D in patients with acute traumatie coagulopathy are related to the occurrence and prognosis of the disease,which deserves further study.