多种损伤因子与重型颅脑损伤凝血功能障碍的相关性研究

目的 探讨内毒素（LPS）、白细胞介素-6（IL-6）、磷脂酶A2（PLA2）、血小板活化因子（PAF）与重型颅脑损伤凝血功能障碍的相关性.方法 收集我院急诊科符合重型颅脑损伤诊断标准的患者65例作为观察组,急诊抢救的同时检测其血小板计数（PLT）、部分活化凝血酶原时间（APTT）、凝血酶原时间（PT）、血浆D-二聚体（D-D）、LPS、IL-6、PLA2、PAF;以同期健康体检者43例作为对照组,对两组检测结果进行统计学分析.结果 两组比较,观察组PLT减少（t=3.892,P＜0.01）,APTT、PT、D-D、LPS、IL-6、PLA2、PAF均升高（t=3.971、3.904、6.532、4.028、4.115、4.274、5.037,P＜0.01）;观察组PLT与LPS、IL-6、PLA2、PAF之间相关系数（r）均≤-0.9319,呈显著负相关;APTT、PT、D-D与LPS、IL-6、PLA2、PAF之间r值均≥0.9091,呈显著正相关.结论 LPS、IL-6、PLA2、PAF参与了重型颅脑损伤凝血功能障碍的发生过程,对LPS、IL-6、PLA2、PAF进行早期干预,可减轻患者凝血功能障碍.

Research on the correlation between multiple damage factors and coagulation disorders after severe craniocerebral injury

Objective To discuss the correlation between lipopolysaccharide （ LPS）, interleukin-6 （ IL-6 ）, phospholipase A2 （ PLA2 ） , and platelet activating factor（PAF） and coagulation disorder after severe craniocerebral injury. Methods Sixty five cases that met the diagnostic criteria of severe craniocerebral injury were selected as observation group. Detection was made in the platelet count （PLT） , activated partial thromboplastin time （AFFr）, prothrombin time （PT）, plasma D-dimer（ D-D ）, LPS, IL-6, PLA2, and PAF at the same time with the emergency rescue. Forty three cases of health examination at the same time were selected as control group. Statistical analysis was made in the detection results between the two groups. Results In the observation group, PLT decreased, and APTT, PT, D- D, LPS, IL-6, PLA2, and PAF all increased （ t = 3. 971,3. 904,6. 532,4. 028,4.115,4. 274, and 5. 037, P 〈 0.01 ）. The correlation coefficient （r） between PLT and LPS, IL-6, PLA2 , and PAF was ≤- 0.9319, and the correlation was negative. But r between AFFF, FF, and D-D and LPS, IL-6,PLA2, and PAF was ≥ 0. 9091, and the correlation was positive. Conclusion LPS, IL-6, PLA2 , and PAF all participate the process of coagulation disorder after severe craniocerebral injury. Early intervention for LPS, IL-6, PLA2 , and PAF can relieve the patients＇coagulation disorder.