颅脑损伤患者急性相蛋白的变化

The Dynamic Changes of Acute Phase Protein in 42 Patients with Acute Head Injuries

报告了42例急性颅脑损伤患者三类急性相蛋白的动态变化。其中C-反应蛋白(CRP)反应最灵敏,42例患者多在伤后2天达峰值,增高幅度为3～24倍。所有患者结合珠蛋白(HPT)也均增高,在伤后4或7天达峰值,约增高1/2～1倍。铜蓝蛋白(CER)仅8例增高,在伤后7或14日达高峰,增高约50%。CRP与HPT增高水平与患者GCS计分、脑实质损伤程度、范围及近期结局相关。故可作为判断急性颅脑损伤患者临床状况的参考指标。CER变化则难以反映颅脑损伤伤情。

Acute phase protein (C-reactive protein-CRP, Haptoglobin-HPT, Ceruidplasmin—CER) response to aoute head injuries in 42 patients were investigated. The result showed that the response of CRP appeared most rapidly in all Patients. It reached the highest concentration. usually 3-24 fold to normal. on the 2nd day after injury. HPT elevated in all patients too, and reached the maximum on the 4 or 7th day after injury. The elevated level of CRP and HPT correlated well with the GCS score, the degree and extent of brain injury and the outcome of patients. An increased CER level beyond normal demonstrated in only 8 patients. It increased rather slowly and reached its peak value at 7 or 14th day after injury. Even if acute phase response is a nonspecific response to head injury, the result from the present study suggest that both CRP and HPT may be used as biochemical marker for the evaluation of clinical status of the patients with acute head injuries But CER is not a valuable pa rameter due to its delayed and mild response to brain damage. (Original article on page 140)