急性颅脑损伤患者血脂变化的临床研究

目的观察不同程度急性颅脑损伤患者血脂水平变化,并探讨其临床意义。方法检测加强医疗病房(ICU)215例中、重型颅脑损伤患者入院24小时内血清总胆固醇(TC)和甘油三酯(TG)水平,其中106例同时检测高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C),将重型颅脑损伤组各血脂水平分别与中型颅脑损伤组、正常对照组比较,并把重型颅脑损伤患者分为死亡组和存活组,比较两组血脂水平。结果重型和中型颅脑损伤组血清TC、TG、LDL-C低于正常对照组,具有显著性差异(P<0.01);重型颅脑损伤患者死亡46例,存活52例,死亡组血清TC低于存活组,具有显著性差异(P<0.05)。结论中、重型颅脑损伤患者伤后早期血脂明显降低,提示在颅脑损伤急性期低TC、低TG和低LDL-C可作为预测病情严重程度和预后的一个参考指标。

Changes of serum lipid level in patients with acute craniocerebral injury

Objective To explore the clinical significance of changes of serum lipid level in patients with acute craniocerebral injury.Methods Serum cholesterol(TC),triglyceride(TG) levels were detected in 215 patients with medium and severe craniocerebral injury in intensive care unit(ICU) in the first 24 hours after admission,and high-density lipoprotein cholesterol(HDL-C) and low-density lipoprotein cholesterol(LDL-C) levels were also detected in 106 of 215.Serum lipid levels were compared between severe craniocerebral injury group,medium craniocerebral injury and normal control group.The patients with severe craniocerebral injury were divided into died group and survival group,serum lipid levels were compared between the two groups.Results The levels of TC,TG and LDL-C in severe craniocerebral injury and medium craniocerebral injury group were significantly lower than those in normal control group(P<0.01),the levels of TC and LDL-C in severe craniocerebral injury group were significantly lower than those in medium craniocerebral injury group(P<0.01).In severe craniocerebral injury group,46 died and 52 were survival.There was no significant different between died and lived patients in the levels of TG,HDL-C and LDL-C.The levels of TC significantly decreased in died patients in comparison with those of the survival patents(P<0.05).Conclusion The lower levels of TC,TG and LDL-C in patients would be parameters that may show the severity of the disease and predict prognosis.