多发伤患者损伤严重程度与血清降钙素原、C反应蛋白及血清胆碱酯酶相关性分析

Correlation of serum procalcitonin,C-reactive protein and cholinesterase in the patients with multiple trauma

目的观察多发伤患者血清降钙素原(PCT)、C反应蛋白(CRP)及血清胆碱酯酶(ChE)的变化,探讨其与患者伤情及出现多器官功能障碍综合征(MODS)的关系。方法多发伤患者62例根据有无MODS发生分为MODS组(31例)与非MODS组(31例)。测定2组伤后第1、2、3、5、7、14天的PCT及CRP水平及伤后24 h内的血清ChE水平,评定损伤严重程度评分(ISS)值,观察患者MODS情况。同时选择同期健康体检者31例为健康对照组,测定PCT、CRP及血清ChE水平。结果多发伤患者创伤后不同时段PCT及CRP水平较健康对照组均升高,MODS组和非MODS组PCT及CRP水平于创伤后第2天达到峰值,之后随着时间变化逐渐下降。MODS组PCT水平较非MODS组高,而CRP水平第7、14天高于非MODS组,差异均有统计学意义(P<0.01)。血清ChE含量健康对照组高于MODS组和非MODS组,非MODS组高于MODS组,差异具有统计学意义(P<0.01)。损伤严重程度评分(ISS)与PCT值呈正相关(r=0.625,P=0.000),而与CRP值无明显的相关性(r=0.047,P=0.718),与血清ChE值呈负相关(r=-0.935,P=0.000)。结论多发伤患者PCT及CRP水平动态变化及血清胆碱酯酶值测定可有效判断伤情,对预测继发性MODS发生有一定价值。

Objective To observe the changes of serum procalcitonin(PCT),C-reactive protein(CRP) and serum cholinesterase(ChE) in multiple trauma patients,and to explore the relationship between the syndrome and multiple organ dysfunction(MODS).Methods Sixty-two multiple injuries patients,according to the presence or absence of MODS,they were divided into MODS group(31 cases) and non-MODS group(31 cases).Determined PCT and CRP levels at after injury’s 1,2,3,5,7,14 days and within 24 h’ s serum levels of ChE,assessed injury severity score(ISS) value,observed the condition of MODS patients.At the same period,31 cases of healthy people were enrolled as healthy control group,PCT,CRP and serum ChE levels of them also were determined.Results Multiple trauma patients,in different periods after injury,the PCT and CRP levels were higher than the healthy control group,MODS group and non-MODS group’ s PCT and CRP levels in second days after injury were reached the peak value,and then decreased gradually with the change of time.The level of PCT in MODS group was higher than the non-MODS group,while the CRP level at seventh,14 th days were higher than in the non-MODS group,the difference was statistically significant(P <0.01).The content of ChE in healthy control group was higher than that in MODS group and non-MODS group,non-MODS group was higher than in MODS group,with statistically significant difference(P <0.01).The ISS was positively correlated with the value of PCT(r =0.625,P =0.000),while no correlation with CRP value(r =0.047,P =0.718),and negatively correlated with serum ChE level(r =0.935,P =0.000).Conclusion Multiple trauma patients’ PCT,CRP and cholinesterase level can effectively assess the injury condition,has prediction value for secondary MODS.