多发伤合并急性创伤性凝血病患者炎症指标动态变化及对预后的影响

目的 探讨多发伤合并急性创伤性凝血病(ATC)患者外周血炎症指标高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)和降钙素原(PCT)及白细胞计数(WBC)的动态变化及其在预后中的意义.方法 收集2018年1月至2020年5月该院收治的多发伤合并ATC患者46例,根据4周后结局将其分为死亡组(16例)和存活组(...

Dynamic changes of inflammatory indicators in patients with multiple injuries complicating acute traumatic coagulopathy and their effect on prognosis

Objective To investigate the dynamic changes of inflammatory indicators high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),procalcitonin(PCT)and white blood cell count(WBC)in peripheral blood of the patients with multiple injuries complicating acute traumatic coagulopathy(ATC)and their significance in prognosis.Methods Forty-six patients with multiple injuries complicating ATC admitted to this hospital from January 2018 to May 2020 were collected and divided into the death group(16 cases)and the survival group(30 cases)according to the outcome in 4 weeks.The coagulation indicators on admission,the levels of WBC,hs-CRP,IL-6 and PCT at 24 h,72 h and on 7 d after trauma were detected.The differences of these inflammatory indexes and coagulation indexes were compared between the two groups,and their influence on the prognosis and outcomes was analyzed by adopting the Logistic regression.Results The ISS score,proportion of complicating traumatic brain injury,fibrinogen(Fbg)level in the death group were significantly higher than those in the survival group(P<0.05);the prothrombin time(PT)was longer that that in the survival group(P<0.05).The levels of hs-CRP and IL-6 at 24 h,72 h and on 7 d after trauma and the PCT level at 24 h and on 7 d after trauma were significantly higher than those in the survival group(P<0.05),and there was no statistical difference in WBC at each time point between the two groups(P>0.05).The Logistic regression analysis showed that complicating traumatic brain injury,hs-CRP at 24 h and on 7 d after trauma and IL-6 at 72 h after trauma were the independent risk factors of prognosis(P<0.05).Conclusion The levels of inflammatory indicators hs-CRP and IL-6 in peripheral blood at the early stage of trauma are of great significance for the prognosis evaluation of the patients with multiple injuries complicating ATC,which could help doctors to formulate the rational treatment scheme to some extent and improve the prognosis of patients.