严重创伤患者血清胱抑素C、脑钠肽联合检测的临床意义

The clinical value of combined detection of serum cystatin C in patients with severe trauma, brain natriuretic peptide

目的 :探讨严重创伤患者血清胱抑素C(CysC)、脑钠肽(BNP)水平的变化及其临床意义。方法 :选取我院收治的创伤严重程度评分(ISS)≥25分的严重创伤患者60例,根据患者是否休克分为A1组(休克31人)与A2组(非休克29人);是否合并颅脑损伤分为A3组(伴颅脑30人)与A4组(不伴颅脑30人);是否死亡分为A5组(死亡18人)与A6组(生存42人)。观察比较各组患者入院第1、3、7天BNP、CysC、肌酐水平变化。结果 :死亡组各时点的CysC、BNP、血肌酐水平均显著高于存活组;伴颅脑损伤组与无颅脑损伤组各时点CysC、血肌酐水平均无明显差别,第3天BNP水平有显著差异;休克组与非休克组第1、3、7天血肌酐水平均有显著差异,第1天CysC水平有显著差异,第7天BNP水平有显著差异;死亡组入院24小时内APACHEⅡ评分显著高于生存组。结论 :严重创伤患者的病情与BNP、CysC水平密切相关,BNP、CysC水平升高提示其预后不佳,检测BNP、CysC可作为病情监测的有效指标,对临床治疗具有一定的参考指导价值。

Objective To investigate the changes of CysC and BNP levels in severe trauma patients and its clinical signifi-cance.Methods60 patients with severe trauma in our hospital were selected, according to whether patients were divided into group A1(shock shock31) and group A2(non shock29); if combined with traumatic brain injury were divided into A3 group (with head30) and A4 group (without head30); whether the death group A5(died18) and group A6(live42). Observe and compare the changes of BNP, CysC and serum creatinine levels in first,3 and 7 days in each group.Results The levels of CysC, BNP and serum creatinine in the death group were significantly higher than those in the survival group; There was no significant dif-ference between the CysC and serum creatinine levels at each time point of the brain injury group and the non traumatic brain injury group, and there was a significant difference in the third day BNP level; There were significant differences in serum cre-atinine levels in the first,3 and 7 days of shock group and non shock group. There were significant differences in CysC levels in first days, and there were significant differences in BNP levels between seventh and days; The APACHE II score in the death group was significantly higher than that in the survival group.Conclusion The condition of severe trauma patients with BNP, CysC levels are closely related, can be used as an effective indicator of disease monitoring, clinical treatment has a certain ref-erence value.