摘要
目的通过研究严重多发伤患者血浆内毒素(lipopolysaccharide,LPS)水平变化,探讨LPS在多发伤病情严重程度及急性胃肠损伤(acute gastrointestinal injury,AGI)程度评估中的作用。方法将81例多发伤患者依据损伤严重度评分法(injury severe score,ISS)进行分组,ISS≤16分为轻伤组(42例),ISS>16分为重伤组(39例),对照组为正常的健康体检人员(40例)。轻伤组和重伤组每名患者在伤后第24、72、120小时分别被采取外周静脉血共计3次,对照组每名健康人员体检时被采取外周静脉血共计1次,血浆LPS检测采用动态浊度法,在相应时间点同时进行AGI分级,最后将血浆LPS与AGI分级进行相关性分析。结果伤后第24小时轻伤组和重伤组血浆LPS检测结果均较对照组有一定程度的上升(P<0.05),且重伤组较轻伤组上升的程度更多(P<0.05)。多发伤患者血浆LPS水平于伤后72 h达到峰值(P<0.05)。伤后第24、72、120小时多发伤患者AGI分级水平与血浆LPS水平均有相关性(P<0.05)。结论血浆LPS检测在评估多发伤患者创伤严重程度和AGI分级中有一定的临床意义。
Objective The objective of this study was to analyze the relationship between the level of plasma lipopolysaccharide （LPS） and acute gastrointestinal injury （AGI） grading in patients with severe multiple injuries. Methods According to the injury severe score （ISS） criteria, 81 patients with multiple injuries were divided into severe multiple injury group （ISS 〉16 points, 39 cases） and mild injury group （ISS ≤16 points, 42 cases） . Another 40 healthy people served as the control group. In the control group, the venous blood was collected once, and the other groups were collected at 24, 72 and 120 h following the injury respectively. The plasma LPS concentration was determined using dynamic turbidimetry. AGI was graded at the corresponding time points, and its correlation with plasma LPS was analyzed. Results The levels of LPS in the mild injury group and the severe injury group both increased significantly as compared with that in the control group at 24 h following the injury （P〈0.05）, and the levels of LPS were significantly higher in severe injury group than those in mild injury group （P〈 0.05）. The plasma LPS level peaked at 72 h following the injury. The plasma levels of LPS were both closely related to the grading of AGI at 24, 72, and 120 h following the injury. Conclusions LPS level has a certain clinical significance in evaluating the severity of trauma and AGI grading in patients with multiple injuries.
作者
李军
李海山
季流
徐礼友
蔡兆辉
章洪院
LI Jun;LI Haishan;JI Liu;XU Liyou;CAI Zhaohui;and ZHANG Hongyuan(Department of Emergency,Hefei Hospital Affiliated to Anhui Medical University,Hefei 230001,China)
出处
《中华灾害救援医学》
2018年第11期606-609,共4页
Chinese Journal of Disaster Medicine
基金
合肥市第二人民医院"光华"青年科研基金重点项目[2017(12)]
关键词
多发伤
急性胃肠损伤分级
血浆内毒素
multiple injuries
acute gastrointestinal injury grading
plasma lipopolysaccharide
