严重多发伤后损伤严重度评分与血清酶含量变化的关系及其临床意义

目的：探讨严重多发伤后损伤严重度评分（ＩＳＳ）与血清酶含量变化的关系及其临床意义。方法：对９２例严重多发伤患者分别在伤后第１天、第７天和第１４天进行ＩＳＳ动态评分，同时测定血清碱性磷酸酶（ＡＬＰ）、天门冬氨酸转氨酶（ＡＳＴ）、丙氨酸转氨酶（ＡＬＴ）、肌酸磷酸激酶（ＣＫ）和乳酸脱氢酶（ＬＤＨ）的含量。结果：严重多发伤组血清ＡＳＴ、ＣＫ、ＬＤＨ水平第１天均显著增高（Ｐ均＜０．０１），第１４天接近正常参考值；ＩＳＳ评分与血清酶含量变化呈正相关；血清酶持续升高者预后差。结论：严重多发伤后血清酶增高水平与创伤严重程度和ＩＳＳ评分相关，测定血清酶有助于判断患者创伤严重程度和评估预后。

The relationship between injury severity scores evaluation and serum enzyme content and its clinical significance after severe multiple injuries

Objective:To explore the relationship between injury severity scores (ISS) evaluation and serum enzyme content and its clinical significance after severe multiple injuries.Methods:ISS of 92 patients with severe multiple injuries were dynamically evaluated at day 1,7 and 14 after acute insults.Meanwhile,serum alkaline phosphatase (ALP),aspartate aminotransferase (AST),alanine transaminase (ALT),creatine kinase (CK) and lactate dehydrogenase (LDH) were also determined.Results:Serum levels of AST,CK and LDH in these patients were significantly high at day l (all P <0 01),but they tended toward normal value at day 14 after injury.ISS evaluation was positively correlated with serum enzyme content,and persistent high serum enzyme level carried out a poor prognosis.Conclusions:It is indicated that high serum enzyme in patients appears to be associated with severe traumatic degree and ISS evaluation.Therefore,measurement of serum enzyme may help to evaluate severe traumatic degree and prognosis.