摘要
目的观察颅脑创伤患者的血脂水平与病情的关系,以指导临床治疗及护理。方法将1 164例颅脑创伤患者按格拉斯哥昏迷评分（GCS）分为重型组（3~8分）125例、中型组（9~13分）310例及轻型组（13~15分）729例,测定入院时及伤后第3天空腹各项血脂值,统计比较各组血脂水平。结果在69岁以下各年龄组患者中,颅脑创伤程度从重型到中型及轻型对应的总胆固醇（TC）水平呈现由低到高的趋势;对应的低密度脂蛋白胆固醇（LDL-C）呈现由低到高的趋势;载脂蛋白B（Apo-B）水平亦呈现由低到高的趋势。这3项指标的差异与颅脑创伤程度具有相关性（P〈0.05）。而在不同颅脑创伤程度的患者中,高密度脂蛋白胆固醇、载脂蛋白A1、三酰甘油和极低密度脂蛋白水平的差异无统计学意义（P〉0.05）。结论颅脑创伤后低密度脂蛋白胆固醇、总胆固醇和载脂蛋白B水平可作为判断颅脑创伤严重程度的参考指标,应重视颅脑创伤患者血脂监测及其对预后的影响,以提高颅脑创伤患者的生存率。
Objective To study the relationship between the changes of blood lipid level and the severity of traumatic brain injury to guide clinical treatment and nursing.Methods 1 164 patients with traumatic brain injury were divided into three basic groups based on their injury severity evaluated by Glasgow Coma Scale（GCS）.125 patients were defined as Severe（GCS 3~8）,310 patients as Moderate（GCS 9~12） and 729 patients as Minor（GCS 13~15）.Fasting blood lipid parameters of the patients were measured on admission and three days after hospitalization and the data were statistically analyzed and compared.Results Significant decreases in the patients′ TC,LDL-C and Apo-B levels were significantly relevant to the increased severity of injuries（P〈0.05）.Corresponding to three levels of severity,namely severe（GCS 3~8）,moderate（GCS 9~12） and minor（GCS 13~15）,the median values of TC were 3.13,3.30 and 3.75 respectively;those of LDL-C were 1.42,1.67 and 1.79 respectively and those of Apo-B were 0.47,0.52 and 0.62 respectively.However no statistically statistical differences were shown in levels of HDL-C,Apo-A1,TG and VLDL（P〉0.05）.Conclusion Blood level of TC,LDL-C and Apo-B can be important parameters to indicate the severity of traumatic brain injury.More efforts are desirable to monitor blood lipid level in brain injury patients and to study the relationship between these parameters and the brain injury prognosis to improve survival rate of brain injury patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第36期4097-4099,4114,共4页
Chinese General Practice
关键词
颅脑创伤
血脂
载脂蛋白B
预后
Craniocerebral trauma
Dyslipidemias
Apolipoprotein B
Prognosis
