心型脂肪酸结合蛋白在早期多发伤合并胸部外伤严重性判断的价值

【】目的 通过测定多发伤合并胸部外伤与无胸部外伤,H-FABP值的比较,从而评价H-FABP在多发伤合并胸部外伤中的早期心肌损伤的诊断价值,以及探讨H-FABP与多发伤的损伤严重程度的相关性。方法 将41例早期(6h以内)多发伤患者,分为合并有胸部外伤为(A组)22例,无胸部外伤为(B组)19例,分别测定H-FABP、cTnI、CK-MB,用非配对t检验进行统计学比较；再以H-FABP以12ng/ml为分界点,比较H-FABP≦12ng/ml与H-FABP﹥12ng/ml两组间休克发生率与死亡率；以及与ISS评分值进行相关性统计分析。结果A、B两组H-FABP的t=2.3885,P<0.05,差异有显著性意义；cTnI的t=0.3319,P>0.05,差异无统计学意义；CK-MB的t=1.5387,P>0.05,差异无统计学意义,多发伤合并胸部外伤早期,H－FABP比cTnI、CK-MB更具有临床意义,可以早期诊断心肌损伤；当H-FABP≦12ng/ml休克发生率17.2%死亡率3.4%,H-FABP>12ng/ml休克发生率83.3%死亡率41.7%,组间休克发生率与死亡率与比较 分别是13.2589和7.1005,P值均小于0．05,有显著差异,且ISS 评分值具有正相关,表明当H-FABP>12ng/ml多发伤患者的预后更差。结论H-FABP可以多发伤合并胸部外伤早期(6h以内)心肌损伤的一个重要指标,可以作为多发伤合并心肌挫伤患者危险分层及严重性评估。

Value of heart fatty acid binding protein in early multiple trauma patients with chest trauma CHEN Fang-hui,WANG Yi , XIAO Chen,CHEN Zi-xi,ZHOU Yue-ting,ZHAO Xue.Emergency Department,Hangzhou First People

Objective by determination of multiple trauma combined chest trauma with no chest trauma, H - FABP value comparison, so as to evaluate the H - FABP in multiple trauma combined chest trauma in the early diagnostic value of myocardial injury, and explore the H - FABP correlation between the severity of injury with multiple trauma Methods 41 cases of early (within 6 H) in patients with multiple trauma, divided into with chest trauma for 22 cases (group A), no chest trauma for 19 cases (group B), respectively, to determine H - FABP cTnI CK - MB, with A paired t test statistical comparison; To H - FABP cut-off for 12 ng/ml, is 12 H - FABP ng/ml and H - FABP 12 ng/ml shock incidence rate and mortality between the two groups. And with ISS score values related to statistical analysis Results A, B two groups of H - FABP t = 2.3885, P < 0.05, significant difference; CTnI t = 0.3319, P > 0.05, there was no statistically significant difference; CK - MB t = 1.5387, P > 0.05, there was no statistically significant difference, polytrauma merger early chest trauma, H - FABP has clinical significance more than cTnI CK - MB, can early diagnosis of myocardial injury; When H - FABP 12 ng/ml 17.2% mortality 3.4% incidence of shock, H - FABP > 12 ng/ml 83.3% mortality 41.7% incidence of shock, shock incidence rate and mortality between group and comparison are respectively 13.2589 and 7.1005, P values were less than 0.05, there was a significant difference, and the ISS score value has a positive correlation, shows that when the H - FABP > 12 ng/ml less the prognosis of patients with multiple trauma Conclusion H - FABP can merge multiple trauma chest trauma, early (within 6h) an important indicator of myocardial injury, can be used as a multiple trauma with risk stratification in patients with myocardial contusion and severity evaluation