创伤性脑损伤(TBI)每年会影响全球数千万人,严重威胁人类健康,军人作为特殊群体尤为高发。目前,对于TBI的临床诊断主要依赖于计算机断层扫描(CT)和格拉斯哥昏迷量表(Glasgow Coma Score,GCS)。然而,CT检测的假阳性和患者暴露于电离辐射...创伤性脑损伤(TBI)每年会影响全球数千万人,严重威胁人类健康,军人作为特殊群体尤为高发。目前,对于TBI的临床诊断主要依赖于计算机断层扫描(CT)和格拉斯哥昏迷量表(Glasgow Coma Score,GCS)。然而,CT检测的假阳性和患者暴露于电离辐射的高风险及GCS存在较大的主观性等限制了TBI尤其是轻中度TBI(mmTBI)的精准诊断。近年来,胶质纤维酸性蛋白(GFAP)和泛素C端水解酶L1(UCH-L1)正在成为新的TBI诊断血液标志物,其应用越来越广泛。该文梳理了GFAP和UCH-L1的理化性质、功能及其在TBI诊断中与已有标志物相比存在的优势,阐述了其在战时环境下的应用潜力,并展望了TBI快速诊断的研发趋势。展开更多
Objective: To investigate a revision of the Trauma and Injury Severity Score (TRISS) weight coefficients in order to overcome the inference from foreign coefficients on Chinese trauma scoring. Methods: The data of ...Objective: To investigate a revision of the Trauma and Injury Severity Score (TRISS) weight coefficients in order to overcome the inference from foreign coefficients on Chinese trauma scoring. Methods: The data of 1 297 Chinese trauma patients were studied for trauma scoring with the Revised Trauma Score Injury Severity Score TRISS (RTS ISS TRISS) system to get a serial of new weight coefficients through analyzing a multivariation logical regression between the outcome and the injury severity. Results: ISS was higher but the Age Score and probability of survival (Ps) of the death group were lower than those of the survival group. New values of RTS ISS Age coefficients differed from the Major Trauma Outcome Study (MTOS) ones, through which the constant b 0 decreased its negative value, and ISS weight b 2 increased its negative value, but RTS weight b 1 and age weight b 3 changed with the trauma types. MTOSs values and new values of weight coefficients were used on 1 297 patients for prognosis by calculating Ps. The accuracy of new values ( 90.13 %) was a little higher than that of MTOSs (89.5%), with a promotion in specialization but a loss in sensitivity. Conclusions: A revision of TRISSs weight coefficients is either necessary or feasible. To achieve this purpose, a Chinese trauma database with large capacity is recommended.展开更多
文摘创伤性脑损伤(TBI)每年会影响全球数千万人,严重威胁人类健康,军人作为特殊群体尤为高发。目前,对于TBI的临床诊断主要依赖于计算机断层扫描(CT)和格拉斯哥昏迷量表(Glasgow Coma Score,GCS)。然而,CT检测的假阳性和患者暴露于电离辐射的高风险及GCS存在较大的主观性等限制了TBI尤其是轻中度TBI(mmTBI)的精准诊断。近年来,胶质纤维酸性蛋白(GFAP)和泛素C端水解酶L1(UCH-L1)正在成为新的TBI诊断血液标志物,其应用越来越广泛。该文梳理了GFAP和UCH-L1的理化性质、功能及其在TBI诊断中与已有标志物相比存在的优势,阐述了其在战时环境下的应用潜力,并展望了TBI快速诊断的研发趋势。
文摘Objective: To investigate a revision of the Trauma and Injury Severity Score (TRISS) weight coefficients in order to overcome the inference from foreign coefficients on Chinese trauma scoring. Methods: The data of 1 297 Chinese trauma patients were studied for trauma scoring with the Revised Trauma Score Injury Severity Score TRISS (RTS ISS TRISS) system to get a serial of new weight coefficients through analyzing a multivariation logical regression between the outcome and the injury severity. Results: ISS was higher but the Age Score and probability of survival (Ps) of the death group were lower than those of the survival group. New values of RTS ISS Age coefficients differed from the Major Trauma Outcome Study (MTOS) ones, through which the constant b 0 decreased its negative value, and ISS weight b 2 increased its negative value, but RTS weight b 1 and age weight b 3 changed with the trauma types. MTOSs values and new values of weight coefficients were used on 1 297 patients for prognosis by calculating Ps. The accuracy of new values ( 90.13 %) was a little higher than that of MTOSs (89.5%), with a promotion in specialization but a loss in sensitivity. Conclusions: A revision of TRISSs weight coefficients is either necessary or feasible. To achieve this purpose, a Chinese trauma database with large capacity is recommended.
