本文選題：創(chuàng)傷性顱腦損傷 + 可溶性尿激酶型纖溶酶原激活物受體�。� 參考：《實用醫(yī)學雜志》2017年02期

【摘要】：目的:探討血漿可溶性尿激酶型纖溶酶原激活物受體(suPAR)及D-二聚體對創(chuàng)傷性顱腦損傷(TBI)患者病情嚴重程度及預后的判斷價值。方法:采用前瞻性研究方法,將急診和重癥醫(yī)學科收治的112例TBI患者根據(jù)GCS評分分為輕度TBI組(GCS:13~15分)、中度TBI組(GCS:9~12分)和重度TBI組(GCS:3~8分),測定患者入院后24 h內血漿su PAR及D-二聚體水平,比較各組間血漿su PAR及D-二聚體水平的差異。結果:與對照組比較,TBI組血漿su PAR、D-二聚體水平均明顯升高(分別為15.86±7.33vs 2.79±0.69,P0.01;3.50±2.78 vs.24±0.15,P0.01)。重度TBI組血漿su PAR、D-二聚體水平亦明顯高于中度TBI組,差異有統(tǒng)計學意義(P0.05)。血漿su PAR水平與GCS評分呈顯著負相關(r=-0.854,P0.01);D-二聚體水平與GCS評分呈負相關(r=-0.738,P0.01);血漿su PAR與D-二聚體呈正相關(r=0.753,P0.01)。D-二聚體的曲線下面積(AUC)值較大,為0.854,95%CI為0.763~0.945;血漿suPAR的AUC值為0.801,95%CI為0.698~0.903。結論:TBI患者血漿suPAR和D-二聚體的升高程度與病情嚴重程度相關,并且預示預后不良。
[Abstract]:Objective: To evaluate the value of plasma soluble urokinase type plasminogen activator receptor (suPAR) and D- two polymer on the severity and prognosis of patients with traumatic brain injury (TBI). Methods: a prospective study was used to divide 112 TBI patients admitted to the Department of emergency and critical medicine into a mild TBI group (GCS:13~15 score) according to the GCS score. The levels of plasma Su PAR and D- two polymer within 24 h after admission were measured in the moderate TBI group (GCS:9~12) and the severe TBI group (GCS:3~8 score). The difference between the plasma Su PAR and D- two polymer levels between the groups was compared. 8 vs.24 + 0.15, P0.01). The level of Su PAR and D- two polymer in the severe TBI group was also significantly higher than that in the moderate TBI group, the difference was statistically significant (P0.05). The level of Su PAR was negatively correlated with GCS score (r=-0.854,); The area under the curve of the.D- two polymer (AUC) was larger, 0.854,95%CI was 0.763~0.945, and the AUC value of plasma suPAR was 0.801,95%CI 0.698~0.903. conclusion: the increase of suPAR and D- two polymer in TBI patients was associated with the severity of the disease, and indicated that the prognosis was poor.
【作者單位】： 武漢市中心醫(yī)院ICU;
【基金】：湖北省武漢市科技局關鍵技術攻關計劃項目(編號:2013060602010252) 湖北省武漢市中心醫(yī)院院內青年科研基金項目(編號:YQ13B09)
【分類號】：R651.15

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