急性脑损伤时内脂素和超敏C-反应蛋白的变化

目的 检测急性颅脑损伤后患者外周血内脂素和超敏C-反应蛋白(hs-CRP)水平的动态变化,探讨其临床意义.方法 120例急性脑损伤患者均为滕州市中心人民医院神经外科及ICU科2009年8月至2010年6月收治住院的患者,其中男60例,女 60例,年龄(43.2±6.2)岁.所有患者均符合颅脑损伤诊断标准.根据入院时格拉斯哥评分(GCS)将患者分为轻度(13～15分)40例,中度(9～12分)40例,重度(3～8分)40例.60例健康体检人员作为对照,其中男30例,女30例,年龄(42.2±6.7)岁.患者于入院后12 h内(即0时间点)及1,3,7,15 d空腹抽取静脉血3 mL用于检测外周血hs-CRP和内脂素的含量变化.结果 急性颅脑损伤患者血清hs-CRP水平均显著高于正常人对照组(3.05±2.08)mg/L(P＜0.01),且患者hs-CRP水平与病情呈正相关;急性颅脑损伤患者血清内脂素含量明显高于正常对照组(17.61±2.45)μg/L(P＜0.01),与病情呈正相关;各组患者在入院当天hs-CRP水平有所升高,并在入院后继续升高,hs-CRP在1 d达高峰,3 d开始下降;内脂素含量在入院当天有所升高,3 d达到高峰,以后逐渐上升;患者内脂素水平与hs-CRP呈正相关(r=0.63,P＜0.01).结论 急性颅脑损伤患者外周血内脂素和hs-CRP水平的变化与病情严重程度密切相关.

Dynamic changes of high-sensitive C-reactive protein and visfatin in patients with acute traumatic injury of brain

Objective To observe the dynamic changes of high-sensitive C-reactive protein (hs-CRP) and visfatin in patients with acute traumatic injury of brain. Method A total of 120 patients with equal number in each gender ( n = 60) and with average age of (43.2 ± 6.2) years were admitted and treated by the neurosurgical department of ICU from August 2009 to June 2010. All patients were eligible to the diagnostic criteria of craniocerebreal injury. The clinical conditions of patients were assessed with Glasgow coma scale (C CS) at admission,and as per the scores of GCS, the patients were classified into mild degree (13- 15, n = 40), moderate degree (9 - 12, n = 40) and severe degree (3 - 8, n = 40). Another 60 subjects from those asking for health care by physical examination as control with equal number in each gender and their average age was (42.2±6.7) years.Blood samples were collected from fasted patients within 12 hours, 1d, 3d, 7d and 15 days after admission, and the levels of hs-CRP and visfatin in peripheral blood were detected. Results The levels of hs-CRP and visfatin were significantly higher in brain injury group than those in control group on the admission day (both P ＜ 0.01 ),and they both had positive relationships with severity of injury. The level of hs-CRP increased to peak on the first day of admission and visfatin increased to the peak on the 3rd day after admission. There was a correlation between levels of hs-CRP and visfatin ( r = 0.63, P ＜ 0.01 ). Conclusions hs-CRP and visfatin levels are related to the severity of acute traumatic injury of brain.